Retrospective study of clinical complications during orthodontic treatment with either a removable mandibular acrylic splint Herbst or with a cantilever Herbst.

OBJECTIVE: To compare the clinical complications during treatment with either a removable mandibular acrylic splint (RMS) or with a cantilever (HC) Herbst appliance.
METHODS: Records from 159 Class II, division 1, consecutively treated patients with a Herbst appliance were examined. The sample was composed of 82 male and 77 female patients with a mean age of 11.8 years. The Herbst appliance was used for a mean of 12 months (standard deviation 2.15 months). Two main Herbst groups were analyzed: group RMS (n  =  125) and group HC (n  =  34). They were further subdivided according to the telescopic system used (Dentaurum type 1 or PMA) and fixation mode (splint with crowns or Grip Tite bands). Patients' clinical records were assessed to identify clinical complications.
RESULTS: The incidence of complications during treatment was 85.3% for the HC group and 88.0% for the RMS group, with no statistically significant difference (Mann-Whitney test, P > .05). The fixation mode (crown or band) also did not show a statistically significant difference (P > .05). Regarding the telescopic system used, the Dentaurum group had 2.9 times more susceptibility to complications than the PMA group, regardless of the Herbst type.
CONCLUSIONS: On average, approximately 2.5 complications per patient were reported. Most patients had a maximum of three complications during Herbst treatment. Herbst appliance type (RMS or HC) and fixation mode (crowns or Grip Tite bands) did not influence the number of complications. The PMA (without screws) telescopic system seemed to be more reliable (regarding the number of complications) than Dentaurum type 1, regardless of the appliance design (RMS or HC).