Herbst Appliance with Four-Miniscrew Anchorage for Mandibular Advancement after the Pubertal Peak

Class II malocclusion has a global prevalence of about 20%, with significant geographic and racial differences,1 and is found in 36-48% of the Caucasian patients presenting for orthodontic treatment.2-4 Although contributing skeletal factors can include maxillary prognathism, mandibular retrognathia, or a combination of both, a retrusive mandible is by far the most common cause.5,6 Traditional methods for correcting the intermaxillary relationship and overjet in Class II cases include fixed or removable functional appliances or multibracket appliances, which may be combined with elastic wear or extractions.