Reduced mandibular cast splints an alternative in Herbst therapy? A prospective multicentre study.

Area of Science:

• Orthodontics
• Craniofacial development

Background:

• Herbst treatment is a common orthodontic approach for Class II division 1 malocclusions.
• Mandibular cast splints are used to enhance anchorage during orthodontic treatment.

Purpose of the Study:

• To compare anchorage loss between reduced (RMS) and total (TMS) mandibular cast splints during Herbst treatment.
• To evaluate the cost-effectiveness of RMS versus TMS.

Main Methods:

• Lateral head films of 66 Class II division 1 patients were analyzed before and after Herbst treatment.
• Anchorage loss was assessed by measuring mandibular incisor proclination, incisor edge position changes, and occlusal plane inclination.
• Student's t-tests were used to compare group differences.

Main Results:

• Lower incisors proclined more in the RMS group (11.8°) than in the TMS group (9.3°).
• Incisal edge advancement was less in the RMS group (2.9 mm) compared to the TMS group (3.7 mm).
• The occlusal plane tilted insignificantly less in the RMS group (5.7°) than in the TMS group (6.3°).

Conclusions:

• Reduced and total mandibular cast splints demonstrated comparable effectiveness in Herbst treatment.
• RMS can be recommended due to their lower cost compared to total splints.
• While RMS showed greater incisor proclination, they resulted in less incisal edge advancement, suggesting a favorable balance of anchorage control.