CASE STUDY on the Herbst appliance and they were placed back on the appliance. I am considering using the VektorPRO Appliance with future Class II cases to avoid Herbst appliance breakage issues. The jaw repositioned within three months resulting in Class I molars and canines. A comparison of before-and-after three months can be seen in (Fig. 5). After 10 months, overjet correction had been fully achieved and the Herbst appliance was removed (Fig. 6). After a discussion, the patient’s mother decided to continue into Phase II. The remaining teeth were bracketed. To make room for the lower #21, 0.012 Niti open coil was placed from LL3 to LL6 with ante-rior anchorage achieved by using ligature wire across the anterior teeth. After four months post Herbst removal, the patient’s over-jet relapsed to 2mm. Instruction for Class II elastics were given. Elastic wear did not achieve the desired overjet correc-Fig. 9: Final cephalometric radiograph. tion. The patient stated that he does wear his elastics. The author concluded that the wear time may not be consistent enough to affect the desired improvement. Treatment time had gone past the 24-month estimation. After discussion with the mother, a Twin Force appliance was placed (Fig. 7). Desired overjet was achieved and the appliance was removed after two months. Braces were removed on February 22, 2017, concluding 34 months of treatment. Much of the extra time involved waiting on improvement of elastic wear. The author would not wait this long in future cases. Fig. 10: Final ceph tracing. www.orthodontics.com Winter 2020 35
Journal of the American Orthodontic Society Winter 2020: Page 35
