The distal bite and its consequences
The Herbst hinge is a fixed, non-removable brace for the orthodontic treatment of a distal occlusion - an underbite of the lower jaw - usually associated with an overbite of the incisors. In newborns, the distal bite is a normal bite, anatomically adapted to the type of feeding. However, in later years, a distal bite can make chewing, speaking and breathing difficult and increase the risk of gingivitis and tooth decay. In addition, the look of the inharmonious facial profile can represent a psychological burden. Functional disorders of the masticatory system also cause long-term consequential damage in other parts of the body, such as cracking of the jaw joint, tension in the muscles in the jaw, throat and neck area as well as headaches and back pain.
The Herbst hinge – the name goes back to its inventor, the dentist Dr. Emil Herbst – resembles a fixed artificial joint that connects the upper and lower jaws. The classic Herbst hinge consists of two splints that are attached to the upper and lower posterior teeth. The splints are connected by hinges to two telescopic rods - consisting of a guide tube and a sliding rod - which push the lower jaw into a medial position, i.e. forward. At the same time, the upper jaw is pushed back slightly by the counter-pressure. The orthodontic appliance thus has a combined dentoalveolar and skeletal effect and reliably normalizes the occlusion. The mobility to the front, to the side and the maximum mouth opening are guaranteed, only the lower jaw can no longer slide backwards with an Herbst hinge in the mouth. Thanks to the thread integrated in the hinge, the telescopes can be easily extended, sometimes using Weingart pliers.
Advantages of the Herbst hinge in orthodontics
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From the moment of insertion, the effect is immediate and uninterrupted, 24 hours a day. The therapy goal can be achieved within a short treatment time of 6 to 9 months, regardless of the compliance of the young patient. This makes the Herbst hinge an effective brace in orthodontics.
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Herbst hinges are now also available for adults up to fourty years of age. These are a real alternative to complex operative dysgnathic surgery.
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The patient's comfort in terms of functionality of the jaw, optics and hygienic care measures is acceptable.
Herbst hinges in LaserMelting
CADdent manufactures orthodontic special products such as elements for Herbst hinges with the highest precision using the LaserMelting process. Like all dental structures produced by CADdent, these Herbst aplliances are also semi-finished products, i.e. preliminary products for our clients’ custom-made products. In the digital design process, we manufacture the bands of the appliance using time- and cost-saving additive LaserMelting, including fitting and polishing. Compared to the previous, often defective casting process, production time is reduced, fit and wearing comfort are increased - and, quite significantly: repairs to the hinge, which is often heavily used in the oral cavity, can be reproduced and fitted promptly and at reduced cost. This is an important financial aspect for patients, because an Herbst hinge is usually not covered by health insurance.
CONCLUSION
Innovative developments in orthodontics are long-lasting, even if they are forgotten in the meantime, like the Herbst hinge. First presented at the beginning of the 20th century by Dr. Emil Herbst, it was only revived by the Swedish orthodontist Prof. Dr. Hans Pancherz in the 1980s and he made the device an internationally recognized treatment method. Today, the Herbst hinge has become indispensable in modern orthodontic practice for the correction of distal bites. This is exactly what CADdent sees as its task: to convert brilliant developments into digital technology and thus carry them on into the future. With the Herbst hinge, we see the use of additive LaserMelting instead of the casting process. The LaserMelting advantages described above in terms of time, costs and repairs are convincing across the board.