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• W4255320434 abstract "We thank the authors of the letter for giving us the opportunity to describe our manuscript better. Every point they raise is a chance for us to elucidate and explain.1.In this pilot study, only patients who needed mandibular advancement were selected. The Herbst appliance (HA) is indicated whenever an esthetic improvement of the lower third of the face can be obtained.2.As the author mentioned, the HA without skeletal anchorage can cause anchorage loss. As mentioned in our article, miniscrews were placed 2 and 4 weeks after HA was settled, and the therapy duration was, on the average, 10 months. We believe that the anchorage loss effects observable in the first 14 days can be assumed to be negligible if we consider the overall duration of the therapy.3.Information about where the miniscrew was placed in the maxillary arch was described in the Material and Methods section; nevertheless, the sentence can be misunderstood. Miniscrews were placed between the first and second premolars, or between the second premolars and the first molars in the attached gingiva, depending on the subject's anatomy.4.As the authors correctly pointed out, maxillary molar distalization can sometimes be useful; in these cases, the primary goal of the therapy is an effective and efficient advancement of the mandible. After the patients have obtained a good anterior relationship, therapy can be carried out according to the patient's need. For example, if molar distalization is useful to relieve anterior crowding, this could be obtained after phase 1 treatment, removing the maxillary screws and working on the distalization in phase 2. The diagnosis leads the treatment plan.5.As mentioned before, the orthodontic treatment plan is diagnosis based; what is important to extrapolate from a pilot study is the possible effects of specific therapies and mechanics, thus a starting point to think on specific patients' orthodontic needs. According to the results of this study, the HA with 4 miniscrews can result in maxillary incisor proclination, and this must be carefully considered when deciding on a patient's treatment. The main reason to use 4 miniscrews and HA is to maximize the skeletal sagittal effect of the functional appliance while maintaining as much control of anterior teeth as possible or, in other words, to use the initial overjet as much as possible to advance the mandible. Herbst appliance anchored with miniscrews: Some unsettled questionsAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 157Issue 3PreviewThe Herbst appliance (HA) is one of the most useful fixed functional appliances for the functional orthopedic correction of Class II malocclusion. However, there are several unwanted side effects, such as the uncontrolled torque of the incisors and the anchorage loss of the molars. The article by Manni et al deals with this issue and, thus, greatly intrigues us (Manni A, Migliorati M, Calzolari C, and Silvestrini-Biavati A. Herbst appliance anchored to miniscrews in the upper and lower arches vs standard Herbst: A pilot study. Full-Text PDF" @default.
• W4255320434 created "2022-05-12" @default.
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• W4255320434 date "2020-03-01" @default.
• W4255320434 modified "2023-09-25" @default.
• W4255320434 title "Authors' response" @default.
• W4255320434 doi "https://doi.org/10.1016/j.ajodo.2019.12.006" @default.
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