@article{nokey,

title = {Airway changes in growing patients after Herbst mandibular advancement devices: a randomized controlled trial (RCT)},

author = {Luísa Schubach da Costa Barreto and Bruno Moreira das Neves and Heeyeon Suh and Heesoo Oh and Klaus Barretto dos Santos Lopes Batista and Jose Augusto Mendes Miguel},

doi = {https://doi.org/10.1016/j.ejwf.2025.07.502},

issn = {2212-4438},

year  = {2026},

date = {2026-01-01},

journal = {Journal of the World Federation of Orthodontists},

volume = {14},

issue = {6},

pages = {558-559},

abstract = {Three-dimensional evaluations of the upper airway with mandibular advancement (MAD) during the growth period have been limited. This randomized controlled trial (RCT) evaluated the skeletal, dental, and upper airway (UA) changes induced by MADs in growing patients with Class II malocclusion, with a particular focus on the Herbst appliance with skeletal (HSA) and dental anchorage (HAD). Forty growing patients were treated with Herbst appliances for 12 months. Cone-beam computed tomography (CBCT) scans were acquired at two time points: pre-treatment (T1) and post-treatment (T2). Three-dimensional analyses were conducted using InVivo7 software to evaluate craniofacial structures, dental relationships, and oropharyngeal space (OP). Key parameters, including ANB, Wits appraisal, overjet, overbite, and UA dimensions, were analyzed. Statistical analyses were performed using R and SPSS, employing intention-to-treat (ITT) methodologies to address missing data. HSA showed the most significant skeletal improvements, with mean reductions of -3.54 mm in Wits appraisal and -1.97° in ANB angle. Dental changes, including reduced overjet, demonstrated the efficacy of MADs in addressing functional and aesthetic concerns. Although UA dimensions showed increased volume and minimum axial area, these changes were not statistically significant. The Herbst appliance demonstrated enhanced mandibular protrusion with minimal dental compensations. MADs effectively corrected skeletal and dental discrepancies in Class II malocclusion, with the HSA group achieving the most pronounced skeletal improvements. While UA volume changes were observed, they lacked statistical significance, underscoring the need for further research into the impact of MADs on airway morphology. These findings highlight the importance of personalized treatment planning to address skeletal, dental, and respiratory needs in growing patients.},

keywords = {Airway Changes, dental anchorage, growing patients, Herbst, RCT},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Airway changes in growing Class II patients treated with Herbst appliance: A randomized controlled trial (RCT) comparing dental and skeletal anchorage},

author = {Luísa Schubach da Costa Barreto and Bruno Moreira das Neves and Deise Caldas Kuhlman and Nathalia Barbosa Palomares and Felipe de Assis Ribeiro Carvalho and Heeyeon Suh and Jonas Bianchi and Heesoo Oh and Klaus Barretto Dos Santos Lopes Batista and José Augusto Mendes Miguel },

url = {https://pubmed.ncbi.nlm.nih.gov/41417024/},

doi = {https://doi.org/10.1080/08869634.2025.2601531},

year  = {2025},

date = {2025-12-19},

journal = {Cranio - Journal of Craniomandibular and Sleep Practice},

pages = {1-13},

abstract = {Objective: To evaluate changes in the oropharyngeal airway (OP) with Herbst appliances using either dental or skeletal anchorage (HDA vs. HSA) in growing patients with Class II division 1 malocclusion. Design, Setting, and Participants: Forty patients (12.6 ± 1.4 years) at the peak of pubertal growth were randomized (HDA= 20; HSA= 20), for 12 months. Outcomes: change in OP volume, airway length and cross-sectional areas (minimum, maximum, average), by CBCT. Results: Thirty-four patients completed the study (HDA= 19; HSA= 15); and intention-to-treat (ITT) analysis was applied. Within-group analysis revealed a significant improvement for minimum axial area (HDA, p =.0061). Between-group comparisons showed significantly higher mean values in the HSA group for volume (p =.0044), airway length (p =.004), maximum cross-sectional area (p =.0188), and average area (p =.0122). Conclusions: HSA and HDA increased OP dimensions in growing Class II patients. Although HSA did not demonstrate a statistically superior effect, the dimensional changes represent morphological adaptations. Long-term studies are required to determine respiratory benefits.},

keywords = {Airway Changes, Angle Class II, Cone-beam computed tomography (CBCT), malocclusion, orthodontic appliances},

pubstate = {published},

tppubtype = {article}

}