Retrognathism - Herbst Appliance
Lorena is a female youth patient treated at our Oxnard office. Lorena was treated for an overbite developed in part as the result of an adolescent growth spurt. The facial structure in young patients can develop in difficult to predict patterns, and a common condition is for the lower jaw to be recessed and undersized creating an overbite sometimes referred to as retrognathism. In order to correct a retrognathic mandible, an Herbst appliance is used. An herbst appliance is fixed to the patient’s upper and lower molars. The appliance contains a very small tube that allows the doctor to make fine adjustments which help to accelerate the growth of the lower jaw and also help bring the resting position of the jaw forward to eliminate the overbite.
In patients who are adults or older teenagers, the facial structure is fully developed and is less malleable to the kinds of adjustments that can be made using the Herbst appliance. In those cases, oral surgery is required to correct the jaw positioning. In younger patients like Lorena, the facial structure is still forming and the doctor is able to use the Herbst appliance to encourage the growth of the jaw and to control its final position. Braces are then used to optimize the alignment of the patient’s teeth so that the teeth are straight and beautiful, and the jaw is in a natural and forward position. Braces alone would not address the growth, expansion, or positioning of the jaw. This is an excellent case study of retrognathism and a great example of the benefits of pursuing orthodontic treatment early in life. By receiving treatment while her facial structure was still developing, Lorena was able to avoid oral surgery as an adult and her case was treated using a passive solution. This case is also an example of why we recommend early orthodontic evaluations. Early orthodontic evaluations can identify conditions, and in many cases preliminary treatments can be performed which will make future orthodontic treatment easier and more effective.