Abstract

Why Choose Traditional Anchorage in Class II Cases with Mandibular Retrusion

by Schiavoni Raffaele

The Herbst appliance represents a well-established therapeutic solution for the treatment of Class II skeletal malocclusions due to mandibular retrusion. Although the use of skeletal anchorage has shown statistically significant results in mandibular advancement, the actual clinical impact remains limited. This shifts the focus to conventional anchorage, which continues to be an effective choice when combined with optimal biomechanical management and careful patient cooperation. The presentation will showcase a series of clinical cases treated with the Herbst appliance using conventional anchorage, highlighting the key factors for the success of the treatment. A fundamental aspect is the control of the occlusal plane rotation during mandibular advancement. This precaution is crucial to ensure the stability of the obtained result and prevent relapses. Controlled rotation helps maintain a balanced and lasting skeletal relationship, contributing to clinical success. Another relevant aspect is the importance of patient cooperation. It is essential that the patient does not resist the appliance, as active interference can accentuate the undesirable effect of proclination of the lower incisors. Finally, the retrusion of point A, often considered an undesirable effect, does not represent a significant clinical problem if the final results are functionally and aesthetically appropriate. The analysis of clinical cases will demonstrate how conventional anchorage, when applied with precise biomechanical criteria, allows for reliable and stable results, making it a predictable, effective, and, above all, non-invasive choice for the treatment of Class II malocclusions due to mandibular retrusion.

Learning Objectives

After this lecture, you will be able to manage of the occlusal plane: Learn techniques to effectively control the counterclockwise rotation of the occlusal plane during mandibular advancement, ensuring skeletal stability and preventing post-treatment relapses.
After this lecture, you will be able to control of A-point retrusion: Understand how to evaluate and manage A-point retrusion, interpreting it not as an adverse effect, but as a functional adaptation that, if correctly integrated into the treatment, contributes to both aesthetic and occlusal balance.
After this lecture, you will be able to control the temporomandibular joint functionality: Acquire tools to monitor and optimize TMJ functionality, ensuring a treatment that not only corrects the malocclusion but also protects and improves joint health in the long term.