Efficiency and outcome quality of Herbst-Multibracket appliance therapy in Class II:2 patients

Objectives: The aim of this retrospective investigation was to generate representative data on the efficiency and outcome quality of Class II:2 Herbst-Multibracket appliance (Herbst-MBA) treatment. Subjects and methods: All Class II:2 patients who had started Herbst-MBA treatment at the study centre since 1986 were included. Study casts from before treatment, after Herbst-MBA treatment, and (if available) after >= 24 months of follow-up were evaluated using standard occlusal variables, the Peer Assessment Rating (PAR)-Index, and the Ahlgren-Scale. Results: During treatment, the pre-treatment PAR score was reduced from 23.6 +/- 7.66 to 5.6 +/- 3.85 (n = 192); during the follow-up period, a slight increase to 6.0 +/- 3.60 occurred (n = 127). The percentage of patients who could be assigned to the PAR category 'greatly improved' was 30% after treatment and 33% after follow-up; only 1%, respectively, 2% had to be assigned to the category 'worse/no different'. The outcome ratings according to the Ahlgren-Scale revealed 20% excellent, 32% good, 46% acceptable, and 2% unsuccessful results. Limitations: Retrospective study design with follow-up data not available from all subjects and no data from untreated controls. Conclusions: Herbst-MBA is an efficient treatment approach in orthodontic care of Class II:2 malocclusions. High-quality results (mean/median PAR score: 5.6/5.0) with very good short-term stability (2.2 years' follow-up) were achieved. Unfortunately, no appropriate control group or groups, where other treatment approaches had been applied, exist.