Herbst Orthodontic Appliances
The Herbst Appliance is used in the treatment of Class II mandibular retrusion malocclusions. It is recommended for patients in which mandibular growth is needed but cooperation with removable functional appliance therapy is a concern. The average treatment time is approximately 8 to 14 months, during which the mandible is advanced initially about 3-4 mm., and then incrementally, until the desired position is achieved.
Herbst appliances may be fabricated with optional devices such as maxillary and or mandibular expansion, buccal tubes, habit cribs, springs, additional bondable rests. Hex head screws are standard on our Herbst appliances but slot screws and flip lock attachments are available.
The latest development in Herbst treatment is the Herbst™ TS—a telescoping mechanism design. The telescoping design provides several key advantages:
The Herbst™ TS is available in three lengths; 18mm, 20, and 22mm. The length is measured from the center of the upper eyelet to the center of the lower eyelet.
The Flip Lock Herbst®
The Flip Lock Herbst
The upper has crowns with axles and arch wire tubes on the first molars. The lower axle is part of a cantilever arm attached to the crowns on the first molars and lower lingual arch. Auxiliaries such as an RPE screw or transpalatal bar can be added.
Acrylic Splint Herbst®
The Splint Herbst is designed with a wire support frame with Herbst attachments at the upper molars and lower first bicuspid area. The acrylic coverage can accommodate bonded or removable styles. The most common are upper bonded with lingual extension on cuspids. Lower removable with full occlusal coverage including incisal cap. The lab will relieve the acrylic for erupting teeth in the bonded or removable styles unless otherwise specified. Auxiliaries such as RPE screw can be added for arch expansion and or posterior cross bite cases. A lower expansion screw can be added if needed.
Hank's Telescoping Herbst®
This appliance represents the latest thinking and design in the herbst appliance. Hank's Telescoping Herbst employs a one piece design by incorporating the screws into the telescoping arms as a single unit. No loose screws! The telescoping design also eliminates the distally extending piston which is prone to causing ulcerations in the mucosa. This design is shorter as well, only extending as far as the mesial of the lower first bicuspid. This design also allows for greater lateral excursion than all previous designs.
Herbst Fabrication Requirements:
1. A set of working models poured in stone or plaster is recommended. Voids should be filled and imperfections should be removed if possible. Trimming the backs of the model to reflect the construction bite is also advised.
2. A construction bite that is 1-3 mm thick at the incisors and reflects the desired advanced position of the mandible (3-4 mm is recommended). It is important to align the skeletal midlines of the patient.
Expansion & Arch
Finishing & Retention
Finishing & Relapse
Pontics & Partials