Perception of changes in soft-tissue profile after Herbst appliance treatment of Class II Division 1 malocclusion

•Early treatment with the Herbst appliance promoted positive changes on the profile.•These changes were noticeable by orthodontists, general dentists, and laypersons.•The laypersons group quantified the greatest changes in the profiles.

IntroductionIn this study, we sought to assess the perception of changes in soft-tissue profile after Herbst appliance treatment by comparing facial profile silhouettes before treatment, immediately after treatment, and 2 years after treatment, as examined by orthodontists, general dentists, and laypersons.MethodsThe sample comprised 21 patients (mean age, 9.5 ± 0.5 years), who were treated with the Herbst appliance for a mean period of 12 (±1.1) months. Three lateral cephalograms were obtained at different times: baseline, immediately after removal of the Herbst appliance, and 2 years after removal of the appliance. The 63 resulting profile silhouettes were evaluated by 120 examiners divided into 3 groups: orthodontists, general dentists, and laypersons. The examiners were instructed to choose their preferred profile and note how much change they perceived across profiles using a visual analog scale.ResultsAll groups of examiners preferred the posttreatment profiles. However, on quantitative assessment, the magnitudes of changes in the profile were found to be variable and rather small, with laypersons quantifying the greatest magnitude of change.ConclusionsEarly Herbst appliance treatment produced positive changes in the facial profile that were visually appreciable both immediately after removal of the appliance and 2 years after treatment.