Department of Orthodontics, Faculty of Dentistry, Hong Kong.
Angle Orthod. 2009 Nov;79(6):1084-94. doi: 10.2319/110308-556R.1.
To compare the treatment effects and long-term stability of the stepwise Herbst appliance and mandibular sagittal split osteotomy in skeletal Class II adult patients.
Subjects comprised 16 patients in the Herbst group and another 16 patients in the surgery (mandibular sagittal split osteotomy) group. Lateral head films were taken before treatment (T0), after removal of the Herbst appliance/surgery (T1), after the fixed appliance treatment (T2), and 3 years after treatment (T3). All films were analyzed by standard cephalometrics and SO-analysis (analysis of changes in sagittal occlusion).
All Herbst and surgery patients were treated successfully to Class I occlusal relationships with normal overjet and overbite. Both groups showed a significant change in mandibular base advancement (SNB, SNPg, Pg/OLp), which resulted in a decrease in the ANB angle, the Wits appraisal, and facial convexity. However, the surgery group showed larger changes in the parameters mentioned above. In terms of long-term stability, both groups achieved stable results, and no significant difference occurred over time.
Stepwise advancement Herbst appliance therapy can be used to treat borderline skeletal Class II adult patients with long-term stability.
比较步步为营式 Herbst 矫治器和下颌矢状劈开截骨术治疗成人骨骼Ⅱ类错颌的疗效及长期稳定性。
研究对象为 Herbst 矫治器组 16 例患者和手术（下颌矢状劈开截骨术）组 16 例患者。在治疗前（T0）、Herbst 矫治器/手术去除后（T1）、固定矫治器治疗后（T2）和治疗 3 年后（T3）拍摄侧头颅定位片。所有的头颅定位片均通过标准头影测量分析和 SO 分析（矢状咬合变化分析）进行分析。
所有 Herbst 矫治器和手术患者均成功地矫正为Ⅰ类咬合关系，正常覆合覆盖。两组下颌基骨均有明显的前伸（SNB、SNPg、Pg/OLp），导致 ANB 角、Wits 评价和面凸度减小。然而，手术组在上述参数方面的变化更大。在长期稳定性方面，两组均获得了稳定的结果，且随时间推移无显著差异。
步步为营式 Herbst 矫治器治疗可用于治疗具有长期稳定性的边缘性成人骨骼Ⅱ类错颌患者。
