Oral Implications of Herbst Device Modification: A Case Report

Background: Many studies analyse the effectiveness of the Herbst device in the treatment of dentoskeletal Class II malocclusion due to mandibular retrusion. This fixed device was devised by Emil Herbst for Class II treatment using a bite jumping, i.e., a device that holds the jaw in a forced anterior position. Comparison of the results obtained in numerous studies is difficult because they are often not comparable and not congruent due to a number of variables that prevent standardization. Methods: The purpose of the present study is to report some clinical-level considerations that may be important in order to obtain more predictable therapeutic outcomes. The simplified design of the Herbst device offers better patient comfort and easier cleanability but may show some disadvantages, such as less anchorage. Results: The device was evaluated in conjunction with the multi-bracket phase that preceded Herbst therapy and concluded after the device was removed. The therapy was performed in the absence of skeletal anchorage. Conclusions: In our opinion, standardization of therapy according to precise protocols may positively affect the therapeutic outcomes by achieving faster occlusal stabilization, more proper neuro-muscular balance, less stress on anchor units, and shorter treatment time.