The Effect of Simultaneous Maxillary Expansion on the Herbst Appliance

Kevin Roberts, Chrysostomos Antoniou, Mithran Goonewardene, Mike Razza

Research output: Contribution to journalArticlepeer-review


Objective: To investigate the impact of simultaneous maxillary expansion on the therapeutic effects of the Herbst appliance.

Materials and Methods: Pre-treatment and post-treatment lateral cephalograms of 28 growing patients who were treated with the Herbst appliance with simultaneous rapid maxillary expansion (Herbst/RME), (mean age 12.50 years, range 10.89 years, 14.13 years) and 19 growing patients treated with the Herbst appliance without expansion (mean age 12.85 years, range 10.42 years, 15.12 years) were analyzed using the method of Pancherz.

Results: In the maxilla, A-point came forward 0.62mm in the Herbst/RME, but was almost stationary for the Herbst (forward 0.13mm). In the mandible, pogonion came forward 3.70mm for the Herbst/RME and 1.18mm for the Herbst. Molar correction was 6.28mm for the Herbst/RME and 4.7mm for the Herbst appliance. Overjet correction was 6.72mm for the Herbst/RME and 4.67mm for the Herbst appliance. The relative contribution to overjet and molar correction was predominantly dental for the Herbst appliance and approximately equally dental and skeletal for the Herbst/RME.

Conclusion: Whilst the use of rapid maxillary expansion has long been demonstrated to be useful to address a transverse discrepancy, this study does not demonstrate an enhanced headgear effect for the correction of a Class II malocclusion when rapid maxillary expansion is undertaken simultaneously with the Herbst appliance.
Original languageEnglish
Pages (from-to)57-70
Number of pages13
JournalSri Lankan Journal of Orthodontics
Issue number1
Publication statusPublished - Feb 2020


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