An Herbst hinge is a fixed mandibular advancement orthodontic appliance used to treat Class II anomalies (distal bite/lower jaw recession).
Angle classes
- I – Neutral bite
- II – distal bite (mandibular recession)
- II 1 – with protruded maxillary anterior (maxillary anterior teeth inclined forward).
- II 2 – with retruded maxillary front (maxillary anterior teeth inclined backward).
- III – mesial bite (mandibular anterior).
Indications (areas of application)
- Scelletal and dental class II anomalies, especially with low residual growth.
- Laterognathia (bite deviation to the side) combined with unilateral Class II
- Lack of compliance with treatment with class II elastics.
The procedure
To promote mandibular growth, an Herbst hinge can be used. It telescopically connects the first maxillary molars (molars) of each side to the mandibular canines of the corresponding side.
The appliance is attached to the teeth with the help of orthodontic bands. It allows the mandible to be moved forward to set the teeth in the desired neutral occlusion (interlocking). In this process, the desired treatment goal can be achieved within a few months.
The Herbst hinge has a more scelletal, less dental effect and experience has shown that it achieves the goal more quickly than the use of Class II elastics. Furthermore, the appliance is fixed and the patient’s cooperation is of less importance than in the context of treatment with elastics, which have to be changed regularly by the patient and also worn.
The appliance is mostly used in patients with little remaining growth, i.e. adolescents and adults up to about 30 years of age.
The achieved treatment result must be fixed afterwards with the help of an advancement double plate or a functional orthodontic appliance to avoid recurrences.
Benefit
The Herbst hinge can also provide treatment for mandibular recession when there is little residual growth. In this way, even young adults can still be adjusted to the all-important, physiologic neutral dentition.
