{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:27:11Z","timestamp":1784294831443,"version":"3.55.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,30]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This controlled study aimed to evaluate the effects of Herbst therapy on the trabecular structure of the condyle and angulus mandible using fractal dimension analysis (FD-A) accompanied by skeletal cephalometric changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Material and method<\/jats:title>\n                  <jats:p>The panoramic and cephalometric radiographs of 30 patients with skeletal Class II malocclusion treated with the Herbst appliance (C II-H group, mean age: 15.23 \u00b1 1.08), 30 patients with skeletal Class II malocclusion that received fixed orthodontic treatment (C II-C group, mean age: 15.73 \u00b1 1.38), and 30 patients with skeletal Class I malocclusion (C I-C group, mean age: 15.90 \u00b1 1.30) were selected. FD-A was performed on the superoposterior region (C-SP) and centre of the condyles (C-C) and the mandibular angulus (Ang) on the panoramic radiographs taken at the pretreatment (T0), intermediate stage of treatment (T1), and posttreatment (T2) timepoints just like cephalometric analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Herbst therapy provided a statistically significant increase in SNB, ANS-Me, Na-Me, S-Go, Co-Gn and a decrease in ANB and overjet (P &amp;lt; 0.05). All skeletal changes remained stable during the fixed appliance treatment after Herbst. The FD values in C-C increased (P &amp;lt; 0.05), and C-SP values decreased (P &amp;lt; 0.05) during Herbst therapy, while after removal of the Herbst appliance, no significant change was observed despite an increase in C-SP. The Ang value did not change during Herbst treatment, but then increased significantly (P &amp;lt; 0.05). There was no significant change in the FD values of the C I-C and C II-C groups at any stage of treatment. The C-C and C-SP changes at T1\u2013T0 period, C-SP and Ang changes at T2\u2013T1 period, and C-C, C-SP, and Ang values at T2\u2013T0 period were found higher in C II-H group compared with the C II-C group significantly (P &amp;lt; 0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Herbst therapy changed the trabecular structure of the condyles in different directions at the superoposterior and central regions of the condyles, while the structural complexity of the angulus mandible, which did not change during the Herbst treatment, increased during the fixed orthodontic treatment after Herbst.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjab048","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T11:09:34Z","timestamp":1624532974000},"page":"125-133","source":"Crossref","is-referenced-by-count":19,"title":["Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis"],"prefix":"10.1093","volume":"44","author":[{"given":"Mehmet","family":"Amuk","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3752-7100","authenticated-orcid":false,"given":"Nisa","family":"Gul Amuk","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,28]]},"reference":[{"key":"2022033005212542400_CIT0001","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S0889-5406(03)00345-7","article-title":"Effectiveness of treatment for Class II malocclusion with the Herbst or twin-block appliances: a randomized, controlled trial","volume":"124","author":"O\u2019Brien","year":"2003","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2022033005212542400_CIT0002","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S1073-8746(97)80056-4","article-title":"The effects, limitations, and long-term dentofacial adaptations to treatment with the Herbst appliance","volume":"3","author":"Pancherz","year":"1997","journal-title":"Seminars in Orthodontics"},{"key":"2022033005212542400_CIT0003","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/ejo\/19.6.657","article-title":"Morphological changes of the TMJ condyles of 100 patients treated with the Herbst appliance in the period of puberty to adulthood: a long-term radiographic study","volume":"19","author":"Paulsen","year":"1997","journal-title":"European Journal of Orthodontics"},{"key":"2022033005212542400_CIT0004","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S0889-5406(99)70285-4","article-title":"Temporomandibular joint remodeling in adolescents and young adults during Herbst treatment: a prospective longitudinal magnetic resonance imaging and cephalometric radiographic investigation","volume":"115","author":"Ruf","year":"1999","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2022033005212542400_CIT0005","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ajodo.2018.02.014","article-title":"Effectiveness of incremental vs maximum bite advancement during Herbst appliance therapy in late adolescent and young adult patients","volume":"155","author":"Amuk","year":"2019","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2022033005212542400_CIT0006","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/0002-9416(80)90277-8","article-title":"Muscle activity in class II, division 1 malocclusions treated by bite jumping with the Herbst appliance. 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