Clinical effects of fixed functional herbst appliance in the treatment of Class II/1 malocclusion.

INTRODUCTION: Sagittal mandible deficiency is the most common cause of skeletal Class II malocclusion. Treatment objective is to stimulate sagittal mandible growth. Fixed functional Herbst appliance use is beneficial for shortening the time required for treatment and does not depend on patient compliance. CASE OUTLINE: A 13-year-old girl was referred to the Clinic of Orthodontics, School of Dentistry in Belgrade following previous unsuccessful treatment of her skeletal Class II malocclusion using an activator. The patient's poor cooperation had led to failure of the treatment. Patient was subjected to the Herbst treatment for 6 months followed by fixed appliance for another 8 months. Lateral cephalograms before and after the treatment was performed. The remodelation of condylar and fossal articulation was assessed by superimposition of pre- and post-treatment temporomandibular joint tomograms. The promotion of oral hygiene and fluoride use was performed because orthodontic treatment carries a high caries risk and risk for periodontal disease. Skeletal and dental changes were observed after treatment (correction [Max+Mand]: molar relation 7 mm, overjet 8 mm, skeletal relation 5 mm, molars 2 mm, incisors 3 mm). Combination of Herbst and fixed appliances was effective in the treatment of dental and skeletal irregularities for a short period of time. CONCLUSION: In the retention period, 14 months after treatment, occlusal stability exists. Follow-up care in oral prevention is based on regular recalls at the dental office and supervision at home by the parents.

[Molar incisor hypomineralisation in the first permanent teeth].

The aim of this study was to point out the prevalence of hypomineralised molars and incisors and emphasize importance of this condition in paediatric dentistry. This condition is defined as hypomineralisation of one or more first permanent molars frequently affecting incisors and referred to as molar incisor hypomineralisation (MIH). Aetiology of MIH has not been fully clarified and numerous aetiological factors have been cited. Hypomineralised molars are more prone to caries, cause severe restorative problems and are frequently extracted due to serious damage and caries complications. Incisors can present demarcated enamel opacities, while enamel breakdown is uncommon. Considering the fact that permanent first molars with severe defects demand complex treatment, they represent a serious problem for the patient as well as for the dentist.