Department of Orthodontics, Justus Liebig University, Giessen, Germany.
Department of Orthodontics, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
J Orofac Orthop. 2024 Jul;85(4):260-269. doi: 10.1007/s00056-023-00457-3. Epub 2023 Feb 24.
To compare the long-term outcome quality (≥ 15 years) of Class II:1 treatment using either a bionator (BIO) or a Herbst-multibracket appliance (HMB).
Patients who underwent functional treatment during the ideal treatment period for the respective approach (prepuberty vs. peak/postpeak) were assessed. Inclusion criteria were overjet ≥ 4 mm, skeletal Class II and availability of study casts from before, after and ≥ 15 years after treatment. The study casts were assessed using the Peer Assessment Rating (PAR) index and standard orthodontic cast measurements.
During treatment, PAR score, overjet and sagittal occlusal relationship improved significantly in all groups. Long-term, there was a significant increase of incisor irregularity in the upper (HMB) and lower (BIO) arch and a significant decrease of lower arch width 3 - 3 (BIO). PAR score, overjet, and sagittal occlusal relationship remained stable long-term. Intergroup comparisons revealed significant differences between the BIO and HMB groups in terms of lower arch width (6 - 6), upper and lower arch width (3 + 3/3 - 3) as well as sagittal molar relationship.
The achieved improvement in PAR score, overjet, and sagittal occlusion remained comparably stable long-term in all groups. The long-term changes are probably a consequence of natural aging.
比较使用肌激动器（BIO）或Herbst 多用途矫治器（HMB）治疗 Class II:1 的长期疗效（≥15 年）。
评估了在各自方法的理想治疗期（青春期前与生长高峰期/后期）接受功能治疗的患者。纳入标准为覆牙合＞4mm、骨骼 Class II 以及治疗前、后和治疗后≥15 年有研究模型。使用同行评估分级（PAR）指数和标准正畸模型测量对研究模型进行评估。
在治疗期间，所有组的 PAR 评分、覆牙合和矢状咬合关系均显著改善。长期来看，上牙弓（HMB）和下牙弓（BIO）的切牙不规则性显著增加，下牙弓宽度 3-3（BIO）显著减小。PAR 评分、覆牙合和矢状咬合关系长期保持稳定。组间比较显示，BIO 组和 HMB 组在下牙弓宽度（6-6）、上下牙弓宽度（3+3/3-3）以及矢状磨牙关系方面存在显著差异。
所有组的 PAR 评分、覆牙合和矢状咬合的改善在长期内均保持相当稳定。长期变化可能是自然老化的结果。
