AdvanSync, CBCT, Class II malocclusion, Fixed functional appliance, Herbst
Citation Information :
Kaushik K, Sidhu MS, Grover S, Dabas A, Dogra N, Nindra J, Bhargarva A. Comparative Three Dimensional Evaluation of Dentoskeletal Parameters using AdvanSync & Herbst Appliance in Class II Malocclusion: “A Randomized Controlled Trial”. World J Dent 2022; 13 (3):228-233.
Aim: To evaluate and compare the dental and skeletal changes of AdvanSync and Herbst appliance using CBCT.
Materials and methods: A single blinded clinical trial was conducted with a total of 39 Class II division 1 patients during their skeletal growth spurt and were randomly divided into three groups; AdvanSync group (n = 13), Herbst group (n = 13), and fixed mechanotherapy group (n = 13) who matched for skeletal age, sex, and craniofacial morphology. CBCT was taken at Pretreatment (T1) stage and Post-treatment stage (T2) after 8 months of appliance placement. Treatment changes were evaluated between these two time points using dentoskeletal variables. Statistical comparisons were done using one-way ANOVA with post hoc Tukey\'s test.
Results: A significant mandibular growth increment with Herbst and significant headgear effect with AdvanSync appliance was observed as compared to fixed mechanotherapy group. Both appliances showed significant increase in total mandibular length, anterior, and posterior facial height.
Conclusion: The AdvanSync and Herbst appliance resulted in correction of the Class II malocclusion. The AdvanSync showed more dentoalveolar effects but less mandibular length increment when compared to Herbst.
Clinical significance: This study suggests that if the Class II malocclusion is due to retrognathic mandible mainly and the patient is in peak pubertal growth spurt, Herbst is the appliance of choice as this appliance supports more skeletal changes while in Class II malocclusion with a more dental and less skeletal contribution AdvanSync appliance works well. Also the age of the patient and compliance support the use of the AdvanSync appliance as for this appliance treatment duration is lesser and it is more patient friendly.
Ruf S, Pancherz H. Dentoskeletal effects and facial profile changes in young adults treated with the Herbst appliance. Angle Orthod 1999;69(3):239–246. DOI: 10.1043/0003-3219(1999)069<0239:DEAFPC>2.3.CO;2
Ruf S, Pancherz H. Herbst/multibracket appliance treatment of class II division 1 malocclusions in early and late adulthood. A prospective cephalometric study of consecutively treated subjects. Eur J Orthod 2006;28(4):352–360. DOI: 10.1093/ejo/cji116
Bock N, Pancherz H. Herbst treatment of class II division 1 malocclusions in retrognathic and prognathic facial types. Angle Orthod 2006;76(6):930–941. DOI: 10.2319/100605-352
Hagg U, Pancherz H. Dentofacial orthopaedics in relation to chronological age, growth period and skeletal development. an analysis of 72 male patients with class II division 1 malocclusion treated with the herbst appliance. Eur J Orthod 1988;10(3):169–176. DOI: 10.1093/ejo/10.3.169
Baccetti T, Franchi L, McNamara JrJA. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72(4):316–323. DOI: 10.1043/0003-3219(2002)072<0316:AIVOTC>2.0.CO;2
Herbst E. Atlas Grundriss der Zahnarztlichen Orthopadie. Munchen J.F. Lehmann Verlag; 1910.
Pancherz H. Treatment of class II malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation. Am J Orthod 1979;76(4):423–442. DOI: 10.1016/0002-9416(79)90227-6
Filho CM. Mandibular protraction appliances for class II treatment. J Clin Orthod 1995;29(5):319–336. PMID: 8617856.
Jasper JJ, McNamara JA. The correction of interarch malocclusions using a fixed force module. Am J Orthod Dentofacial Orthop 1995;108(6):641–650. DOI: 10.1016/s0889-5406(95)70010-2
Eckart E. Introducing the MARA. Clinical Impressions 1998;7:2–5.
Dischinger BM. Skeletal class II case presentation: utilization of the Advansync2 appliance. APOS Trends Orthod 2018;8(3):168–174. DOI: 10.4103/apos.apos_64_18
Obijou C, Pancherz H. Herbst appliance treatment of class II division 2 malocclusions. Am J Orthod Dentofacial Orthop 1997;112(3):287–291. DOI: 10.1016/S0889-5406(97)70258-0
Jayachandran S, Wiltshire WA, Hayasaki SM, et al. Comparison of AdvanSync and intermaxillary elastics in the correction of class II malocclusions: a retrospective clinical study. Am J Orthod Dentofacial Orthop 2016;150(6):979–988. DOI: 10.1016/j.ajodo.2016.05.008
Al- Jewair T, Preston CB, Moll EM, et al. A comparison of the MARA and the AdvanSync functional appliances in the treatment of class II malocclusion. Angle Orthod 2012;82(5):907–914. DOI: 10.2319/090411-569.1
Nelson B, Hansen K, Hägg U. Class II correction in patients treated with class II elastics and with fixed functional appliances: a comparative study. Am J Orthod Dentofacial Orthop 2000;118(2):142–149. DOI: 10.1067/mod.2000.104489
Charlier JP, Petrovic A, Herrmann-Stutzmann J. Effects of mandibular hyperpropulsion on the prechondroblastic zone of young rat condyle. Am J Orthod 1969;55(1):71–74. DOI: 10.1016/s0002-9416(69)90174-2
McNamara JA. Neuromuscular and skeletal adaptations to altered function in the orofacial region. Am J Orthod 1973;64(6):578–606. DOI: 10.1016/0002-9416(73)90290-x
McNamara JA. Functional adaptations in the temporomandibular joint. Dent Clin North Am 1975;9(3):457–471. PMID: 805721.
Sidhu MS, Kharbanda OP, Sidhu SS. Cephalometric analysis of changes produced by a modified Herbst appliance in the treatment of class II division 1 malocclusion. Br J Orthod 1995;22(1):1–12. DOI: 10.1179/bjo.22.1.1
You ZH, Fishman LS, Rosenblum RE, . Dentoalveolar changes related to mandibular forward growth in untreated class II personset al. Am J Orthod Dentofacial Orthop 2001;120(6):598–607. DOI: 10.1067/mod.2001.119801
Serbesis-Tsarudis C, Pancherz H. “Effective” TMJ and chin position changes in class II treatment. Angle Orthod 2008;78(5):813–818. DOI: 10.2319/082707-391.1
Johnston LE Jr. Growing jaws for fun and profit: a modest proposal. Craniofacial growth Series. Ann Arbor: Centre for Human Growth and Development; University of Michigan;1998.
Pancherz H. The mechanism of class II correction in Herbst appliance treatment: a cephalometric investigation. Am J Orthod 1982;82(2):104–113. DOI: 10.1016/0002-9416(82)90489-4