Orthodontic Class II:1 treatment-efficiency and outcome quality of Herbst-multibracket appliance therapy.

OBJECTIVES: The aim of this retrospective investigation was to assess the efficiency and outcome quality of Class II:1 treatment (Tx).

MATERIAL AND METHODS: The investigation is based on the evaluation of all Class II:1 patients that ever (1986-2014) started Tx with a Herbst appliance and subsequently a multibracket appliance (MBA) at the study center. Study casts from before Tx, after Herbst-MBA Tx, and (if available) after ≥ 24 months of retention were evaluated using the Peer Assessment Rating (PAR) index, the Ahlgren scale, and standard occlusal variables.

RESULTS: In total, 526 Class II:1 patients with a mean pre-Tx age of 14.4 years (range 9.8-44.4) had received Herbst-MBA Tx; 18 patients discontinued Tx before completion. For 240 patients, data from ≥ 24 months of retention were available. The pre-Tx PAR score of 32.4 ± 8.83 was reduced to 8.0 ± 4.51 during Tx. A slight increase to 8.8 ± 5.11 occurred during retention. The percentage of patients which could be assigned to the category "greatly improved" was 62% after Tx and 57% after retention; only 2-3% had to be assigned to the category "worse/no different." The outcome ratings according to the Ahlgren scale revealed 17% excellent, 35% good, 45% satisfactory, and 3% unsuccessful results.

CONCLUSIONS: Class II:1 Tx using Herbst-MBA is an efficient approach in orthodontic care. During a mean active Tx period of 2 years, high-quality results can be obtained in the majority of patients.

CLINICAL RELEVANCE: The present investigation is the first to investigate a large unselected cohort of consecutive Herbst-MBA patients to determine representative data on the efficiency and the outcome quality of this Tx approach.