Class II – Herbst Treatment
Initial: Patient has the appearance of “bucked teeth” and upper front teeth lower on her right than her left. In this patient the teeth are positioned off by an entire tooth. The upper teeth need to move backwards one tooth and the lower teeth need to move forward an entire tooth. In this patient we also evaluate the profile and the positions of the upper and lower jaws. A determination was made that the upper front teeth were forward but it was compounded by the fact that the lower jaw was positioned backward.
Treatment: The patient started with a Herbst appliance which positions the lower jaw forward and allows growth and remodeling of the bones to correct the skeletal relationship. The patient wore the Herbst appliance for a year as the remainder of the permanent teeth erupt. When the Herbst was removed braces were put on all the permanent teeth and the occlusion was finalized in one year. Not only does the Herbst appliance correct the front to back relationship of the teeth and jaws but it also limits the time spent in full braces and elastics.
Final: This patient has a beautiful smile without extractions and jaw surgery as a result of current technology. The patients profile was dramatically impacted and the smile is what she had dreamed it would be. Note the change in the upper and lower jaw positions (this can best be seen in the x-ray and facial photos of the side of the head).