Herbst vs Surgery

[OrthodontistExpert]

I think this is a great video to show the difference on facial growth using a Herbst vs IMDO surgery on treating the big overbite
You tell me which is the better way

http://m.youtube.com/watch?list=PLjC4hIwmyQfjXgckxslgVI9BPkh6wcv-a&v=STpvxw5viQA

[nrelax11]

I had the Herbst device when I was in high school, and if I could I would have rather had IMDO. That was in 2006 and I dont know when DO started being used, but I was never offered the option nor did I even know of any other option.

[OrthodontistExpert]

Orthodontists rarely offer surgery. Orthodontists offer what they can do.

You can't blame us. We are not surgeons. We are not real doctors. We are dentists.

The fundamental condition underscoring the big overbite, is the small lower jaw.
There is literally no treatment to correctly grow a small lower jaw in all three dimensions.

When you have an overbite, everyone attempts to validate the facial skeleton in profile using a lateral cephalogram. This doesn't take account that the lower jaw is three dimensionally small.

And it is also asymmetrically small.

And as the mandible is small... The teeth become crowded... The airway is narrow... And the normal upper jaw grows narrowly... And often with impactions like canine or wisdom teeth.

There is NO known treatment to grow the small lower jaw three dimensionally. There is NO known treatment to grow it in children in a way that proportionally widens the lower face, lengthens the lower jaw, perfectly aligns the bite, cures you of all dental impactions, and at the same time potentially avoids orthodontics.

IMDO offers all of that. It's new. It's not yet published. There are hundreds of people that have already been treated.

It's a real game changer.

[Ashantier]

The following post is interesting too.

[treevernal]

The herbst destroyed my face.  Rather than guiding lower jaw growth it kept my upper jaw from growing forward and put so much stress on my tmjs.  This was all confirmed by my surgeon and they are common problems with the device.

[treevernal]

How old were you when you had herbst appliance?

I too think "orthopedic" non-surgical treatments can be disastrous too, especially in the wrong hands.

I was 13.

[molestrip]

What's the consensus then about this? About all I can gather so far is either IMDO or, just do reverse pull headgear during growth and plan on moving the mandible to match at age but that leaves you with a screwed up bite for many years and damage to joints in the mean time. I want to know what I should do for my kids.

[notrain]

What's the consensus then about this? About all I can gather so far is either IMDO or, just do reverse pull headgear during growth and plan on moving the mandible to match at age but that leaves you with a screwed up bite for many years and damage to joints in the mean time. I want to know what I should do for my kids.

nothing but surgery can lengthen the corpus of the mandible. If you don't trust IMDO yet (reasonable) then leave your kids alone and get them combined treatment once they are fully grown. orthodontics are useless for underlying skeletal issues. they can't grow the mandible, they can only swing it forward at the joint level, but that doesn't make the actual jaw bigger.

Personally I think if IMDO turns out to be reliable, i.e. a couple of thousand patients treated AND no problems after a decade, then it's probably the best treatment available. You can start expanding the UPPER jaw using orthodontics and once that's done do IMDO and voilà you have a normal facial skeleton in a previously deformed adolescent.