Angle Orthod. 2018 Jan;88(1):3-9. doi: 10.2319/060117-369.1. Epub 2017 Oct 10.
To determine the relative effects of Herbst appliance therapy in hypo- and hyperdivergent patients.
The treated group included 45 growing Class II, division 1, patients treated with stainless steel crown Herbst appliances, followed by fixed edgewise appliances. The untreated control group consisted of 45 Class II, division 1, subjects, matched to the treated sample based on Angle classification, age, sex, and pretreatment mandibular plane angle (MPA). Subjects were categorized as hypo- or hyperdivergent based on their MPAs. Pre- and posttreatment cephalograms were traced and superimposed on cranial base and mandibular structures.
The primary effect of the Herbst in terms of maxillomandibular correction was in the maxilla. It significantly restricted maxillary growth, producing a "headgear effect." Mandibular treatment changes depended on divergence. Hyperdivergent patients experienced a deleterious backward true mandibular rotation with Herbst treatment. Hypodivergent patients, as well as untreated hypo- and hyperdivergent controls, underwent forward true mandibular rotation. However, hypodivergent chins did not advance any more than expected for untreated hypodivergent Class II patients.
Hypo- and hyperdivergent patients benefit from the Herbst's headgear effect. While the mandibular growth of hypodivergent patients overcomes the negative rotational effects, hyperdivergent patients undergo a deleterious backward mandibular rotation and increases in facial height.
确定 Herbst 矫治器治疗低角和高角患者的相对效果。
实验组包括 45 名生长发育期安氏Ⅱ类 1 分类错（牙合）患者，采用不锈钢冠 Herbst 矫治器治疗，随后使用方丝弓矫治器固定。未治疗的对照组包括 45 名安氏Ⅱ类 1 分类错（牙合）患者，根据 Angle 分类、年龄、性别和治疗前下颌平面角（MPA）与治疗组相匹配。根据 MPA 将患者分为低角或高角。治疗前后的头颅侧位片通过头影测量分析，并对颅底和下颌结构进行重叠。
Herbst 矫治器在颌骨矫正方面的主要作用是在上颌。它显著限制了上颌的生长，产生了“头帽效应”。下颌的治疗变化取决于分散度。高角患者在 Herbst 治疗后出现有害的下颌真性后旋。低角患者以及未治疗的低角和高角对照组则经历了下颌真性前旋。然而，低角颏部的前移并不比未治疗的低角安氏Ⅱ类患者预期的更多。
低角和高角患者均受益于 Herbst 矫治器的头帽效应。低角患者的下颌生长克服了负旋的影响，而高角患者则经历了有害的下颌真性后旋和面高增加。
