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

Class II malocclusion has aglobal prevalence of about20%, with significant geographicand racial differences,1and is found in 36-48% of the Caucasianpatients presenting fororthodontic treatment.2-4 Althoughcontributing skeletal factors caninclude maxillary prognathism,mandibular retrognathia, or a combination of both, a retrusive mandibleis by far the most commoncause.5,6 Traditional methods forcorrecting the intermaxillary relationshipand overjet in Class II casesinclude fixed or removable functionalappliances or multibracketappliances, which may be combinedwith elastic wear or extractions.