Herbst 疗法的 32 年随访研究：一项生物计量牙模分析。
Thirty-two-year follow-up study of Herbst therapy: a biometric dental cast analysis.
机构信息
Professor and chair emeritus, Department of Orthodontics, University of Giessen, Giessen, Germany.
Associate professor, Department of Orthodontics, Faculty of Dentistry, University of Malmö, Malmö, Sweden.
出版信息
Am J Orthod Dentofacial Orthop. 2014 Jan;145(1):15-27. doi: 10.1016/j.ajodo.2013.09.012.
INTRODUCTION
The aim of this study was to analyze the very long-term effects of Herbst treatment on tooth position and occlusion.
SUBJECTS
Fourteen patients from a sample of 22 with Class II Division 1 malocclusions consecutively treated with the banded Herbst appliance were reexamined 32 years after therapy.
METHODS
Dental casts were analyzed from before (T1) and after (T2) treatment, and at 6 years (T3) and 32 years (T4) after treatment.
RESULTS
Minor changes in maxillary and mandibular dental arch perimeters and arch widths were seen during treatment (T1-T2) and posttreatment (T2-T4). Mandibular incisor irregularity remained, on average, unchanged from T1 to T2 but increased continuously during the 32-year follow-up period (T2-T4). Class II molar and canine relationships were normalized in most patients from T1 to T2. During the early posttreatment period (T2-T3), there was a minor relapse; during the late posttreatment period (T3-T4), molar and canine relationships remained, on average, unchanged. Overjet and overbite were reduced to normal values in all subjects during treatment (T1-T2). After treatment (T2-T4), overjet remained, on average, unchanged, but overbite increased insignificantly.
CONCLUSIONS
Thirty-two years after Herbst therapy, overall, acceptable long-term results were seen. Stability was found in 64% of the patients for sagittal molar relationships, in 14% for sagittal canine relationships, in 86% for overjet, and in 86% for overbite. A Class II relapse seemed to be caused by an unstable interdigitation of the occluding teeth, a persisting oral habit, or an insufficient retention regimen after treatment. Most posttreatment changes occurred during the first 6 years after treatment. After the age of 20 years, only minor changes were noted. Long-term posttreatment changes in maxillary and mandibular dental arch perimeters and widths as well as in mandibular incisor irregularity seemed to be independent of treatment and a result of physiologic dentoskeletal changes throughout adulthood.
简介
本研究旨在分析 Herbst 治疗对牙齿位置和咬合的长期影响。
对象
22 例安氏Ⅱ类 1 分类错颌畸形患者连续接受带环 Herbst 矫治器治疗，其中 14 例患者在治疗结束后 32 年被重新检查。
方法
对治疗前（T1）、治疗后（T2）、治疗后 6 年（T3）和治疗后 32 年（T4）的牙模进行分析。
结果
治疗期间（T1-T2）和治疗后（T2-T4）上颌和下颌牙弓周长和宽度有轻微变化。下颌切牙不齐在 T1 到 T2 时基本保持不变，但在 32 年的随访期间持续增加。大多数患者的Ⅱ类磨牙和尖牙关系在 T1 到 T2 时得到纠正。在早期治疗后阶段（T2-T3），有轻微复发；在晚期治疗后阶段（T3-T4），磨牙和尖牙关系基本保持不变。所有患者在治疗期间（T1-T2）的覆盖和覆颌均减少至正常。治疗后（T2-T4），覆盖基本保持不变，但覆颌略有增加。
结论
在 Herbst 治疗后 32 年，总体上取得了可接受的长期效果。64%的患者矢状向磨牙关系稳定，14%的患者矢状向尖牙关系稳定，86%的患者覆盖正常，86%的患者覆颌正常。Ⅱ类复发似乎是由于咬合牙齿的不稳定嵌合、持续的口腔习惯或治疗后保持器不足引起的。大多数治疗后变化发生在治疗后 6 年内。20 岁以后，仅观察到轻微的变化。上颌和下颌牙弓周长和宽度以及下颌切牙不齐的长期治疗后变化似乎与治疗无关，而是整个成年期生理牙颌变化的结果。
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