Specialty M4® Herbst

The MIO is a measurement Specialty Appliances™ uses to size MiniScopes for each patient. The wrong-sized MiniScope may allow the patient to pull off the lower crowns because they are not able to fully achieve their MIO.

If we have the MIO, we can provide you with the correct size MiniScope, and the patient cannot dislodge their appliance.

The MIO is the measurement of the distance from the upper to the lower incisal edges with the patient opening to the limit of their comfortable, pain-free range.

Add the amount of overbite to that dimension for an accurate MIO measurement.

Phase I treatment is justified when a patient has a severe Class II malocclusion or the patient experiences ridicule at school.

The Herbst will usually change a patient's profile immediately, helping them look more natural to their peers.

Patients are treated from 9 to 16 months in Phase I, depending on the severity of their Class II malocclusion.

Patients are ideally started in Herbst® treatment between the ages of 11 and 12.

This allows for the maximum effect of the Herbst during their growth spurt. The age can vary depending on the maturity of the patient.

It's believed that the main effects of the Herbst in adults are joint remodeling and dental-alveolar changes.

We've made hundreds of Herbst appliances for adults, some even in their fifties.

If patients are in a posterior cross-bite, the upper member of the Herbst appliance will often have to be expanded before the mechanism is attached.

However, the new telescoping mechanisms with the AppleCore® screws allow you to insert the complete appliance due to the flexibility they offer.

We'll usually advance a Class II or a Class II Division II patient to an end-to-end advancement. This is only done if the distance is less than 8 millimeters.

A Class II Division I patient will be advanced to Class I molars. However, your prescribed advancement will overrule our standards.

Generally, the patients are held in the corrected position for 9 to 12 months. The severity of the Class II determines this.

An easy way to determine if the condyle is centered is to remove the Herbst® mechanism and wait for one month.

If the patient has relapsed, simply reattach the mechanism and continue treatment for three months.

We add archwire tubes to the upper and lower arch on 90% of all Herbst® appliances we construct.

This allows the clinician to tie the upper arch together to limit the "headgear effect" and level the lower arch during treatment.

The upper right screw tends to loosen and can fall out. To prevent this, add a few drops of Ceka Bond to the threads when seating the appliance.