{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:38:14Z","timestamp":1783125494951,"version":"3.54.6"},"reference-count":62,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:\u2002<\/jats:title>\n                    <jats:p>To analyze radiographic signs of temperomandibular joint (TMJ) osteoarthritis and clinical TMJ symptoms in patients 6 years and 32 years after treatment with a Herbst appliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:\u2002<\/jats:title>\n                    <jats:p>Fourteen patients were derived from a sample of 22 with Class II division 1 malocclusions consecutively treated with a banded Herbst appliance at the age of 12\u201314 years old (T1-T2). The subjects were reexamined after therapy at the ages of 20 years (T3) and 46 years (T4). The TMJs of the 14 patients were analyzed radiographically (conventional lateral tomography at T3 and cone-beam computed tomography at T4) and clinically\/anamnestically at T3 and T4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:\u2002<\/jats:title>\n                    <jats:p>Six years after Herbst therapy, signs of osteoarthritis were seen in one patient. At the 32-year follow-up, two additional patients had developed signs of osteoarthritis. At the 6-year follow-up, TMJ clicking was present in two patients, though none of the patients reported TMJ pain. At the 32-year follow-up, six patients had TMJ clicking and one patient had TMJ pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:\u2002<\/jats:title>\n                    <jats:p>This longitudinal very-long-term follow-up study after Herbst therapy revealed only minor problems from the TMJ. The TMJ findings 6 years and 32 years after Herbst treatment corresponded to those in the general population. Thus, in the very long term, the Herbst appliance does not appear to be harmful to the TMJ.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/072914-530.1","type":"journal-article","created":{"date-parts":[[2014,12,31]],"date-time":"2014-12-31T10:38:30Z","timestamp":1420022310000},"page":"735-742","source":"Crossref","is-referenced-by-count":16,"title":["Signs and symptoms of TMJ disorders in adults after adolescent Herbst therapy: A 6-year and 32-year radiographic and clinical follow-up study"],"prefix":"10.2319","volume":"85","author":[{"given":"Hans","family":"Pancherz","sequence":"first","affiliation":[{"name":"Professor and Chair Emeritus, Department of Orthodontics, University of Giessen, Giessen, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Sal\u00e9","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malm\u00f6 University, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krister","family":"Bjerklin","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Orthodontics, Faculty of Odontology, Malm\u00f6 University, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"b1","series-title":"The Herbst Appliance. Research-based Clinical Management","author":"Pancherz\n              H,","year":"2008","unstructured":"Pancherz\n              H, \n            \n              Ruf\n              S. \n          \n          The Herbst Appliance. Research-based Clinical Management. London, UK: Quintessence Publishing Co Ltd; 2008."},{"key":"b2","series-title":"Orthod Fr","first-page":"79","article-title":"MRI study of the temporomandibular joint disk behavior in children with hyperpropulsion appliances","volume":"69","author":"Foucard\n              JM,","year":"1998","unstructured":"Foucard\n              JM, \n            \n              Pajoni\n              D, \n            \n              Carpentier\n              P, \n            \n              Pharaboz\n              C. \n          \n          MRI study of the temporomandibular joint disk behavior in children with hyperpropulsion appliances. Orthod Fr. 1998;69:79\u201391."},{"key":"b3","series-title":"Am J Orthod Dentofacial Orthop","first-page":"475","article-title":"Long-term TMJ effects of Herbst treatment: a clinical and MRI study","volume":"114","author":"Ruf\n              S,","year":"1998","unstructured":"Ruf\n              S, \n            \n              Pancherz\n              H. \n          \n          Long-term TMJ effects of Herbst treatment: a clinical and MRI study. Am J Orthod Dentofacial Orthop. 1998;114:475\u2013483."},{"key":"b4","series-title":"Angle Orthod","first-page":"183","article-title":"Does bite-Jumping damage the TMJ? A prospective longitudinal clinical and MRI study of Herbst patients","volume":"70","author":"Ruf\n              S,","year":"2000","unstructured":"Ruf\n              S, \n            \n              Pancherz\n              H. \n          \n          Does bite-Jumping damage the TMJ? A prospective longitudinal clinical and MRI study of Herbst patients. 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Eur J Orthod. 1982;4:37\u201344."},{"key":"b6","series-title":"Eur J Orthod","first-page":"244","article-title":"Long-term effects of the Herbst appliance on the craniomandibular system with special reference to the TMJ","volume":"12","author":"Hansen\n              K,","year":"1990","unstructured":"Hansen\n              K, \n            \n              Pancherz\n              H, \n            \n              Petersson\n              A. \n          \n          Long-term effects of the Herbst appliance on the craniomandibular system with special reference to the TMJ. Eur J Orthod. 1990;12:244\u2013253."},{"key":"b7","series-title":"Am J Orthod","first-page":"104","article-title":"The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation","volume":"82","author":"Pancherz\n              H.","year":"1982","unstructured":"Pancherz\n              H. \n          \n          The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation. Am J Orthod. 1982;82:104\u2013113."},{"key":"b8","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"844","article-title":"Research diagnostic criteria for mandibular disorders (RDC\/TMD): development of images analysis criteria and examiner reliability for image analysis","volume":"107","author":"Ahmad\n              M,","year":"2009","unstructured":"Ahmad\n              M, \n            \n              Hollender\n              L, \n            \n              Andersson\n              Q, \n            et al\n          . Research diagnostic criteria for mandibular disorders (RDC\/TMD): development of images analysis criteria and examiner reliability for image analysis. 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Int J Oral Maxillofac Surg. 2012;41:690\u2013695."},{"key":"b24","series-title":"Oral Surg Oral Med Oral Pathol","first-page":"416","article-title":"Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material","volume":"78","author":"Widmalm\n              SE,","year":"1994","unstructured":"Widmalm\n              SE, \n            \n              Westesson\n              PL, \n            \n              Kim\n              IK, \n            \n              Pereira\n              FJ\n              Jr, \n            \n              Lundh\n              H, \n            \n              Tasaki\n              MM. \n          \n          Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material. 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A cephalometric investigation. Am J Orthod. 1982;82:104\u2013113."},{"key":"b8","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"844","article-title":"Research diagnostic criteria for mandibular disorders (RDC\/TMD): development of images analysis criteria and examiner reliability for image analysis","volume":"107","author":"Ahmad\n              M,","year":"2009","unstructured":"Ahmad\n              M, \n            \n              Hollender\n              L, \n            \n              Andersson\n              Q, \n            et al\n          . Research diagnostic criteria for mandibular disorders (RDC\/TMD): development of images analysis criteria and examiner reliability for image analysis. 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J Craniomandib Disord. 1992;6:301\u2013355."},{"key":"b11","series-title":"J Orthop Trauma","first-page":"177","article-title":"Loss of follow-up in orthodontic trauma: is 80% follow-up still acceptable","volume":"27","author":"Zelle\n              BA,","year":"2013","unstructured":"Zelle\n              BA, \n            \n              Bhandari\n              M, \n            \n              Sanches\n              AI, \n            \n              Probst\n              C, \n            \n              Pape\n              HC. \n          \n          Loss of follow-up in orthodontic trauma: is 80% follow-up still acceptable? J Orthop Trauma. 2013;27:177\u2013181."},{"key":"b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"15","article-title":"A 32-year folllow-up study of Herbst therapy. A biometric dental cast analysis","volume":"145","author":"Pancherz\n              H,","year":"2014","unstructured":"Pancherz\n              H, \n            \n              Bjerklin\n              K, \n            \n              Lindskog-Stockland\n              B, \n            \n              Hansen\n              K. \n          \n          A 32-year folllow-up study of Herbst therapy. A biometric dental cast analysis. Am J Orthod Dentofacial Orthop. 2014;145:15\u201327."},{"key":"b13","series-title":"Am J Orthod Dentofacial Orthop","article-title":"Late adult skeletofacial growth after adolescent Herbst therapy. A 32-year longitudinal follow-up study","author":"Pancherz\n              H,","year":"2015. In press","unstructured":"Pancherz\n              H, \n            \n              Bjerklin\n              K, \n            \n              Hashem\n              K. \n          \n          Late adult skeletofacial growth after adolescent Herbst therapy. A 32-year longitudinal follow-up study. Am J Orthod Dentofacial Orthop. 2015. In press."},{"key":"b14","series-title":"Dentomaxillofacial Radiol","first-page":"192","article-title":"Cone beam CT and conventional tomography for the detection of morphological temporomandiblar joint changes","volume":"36","author":"Hintze\n              H,","year":"2007","unstructured":"Hintze\n              H, \n            \n              Wiese\n              M, \n            \n              Wentzel\n              A. \n          \n          Cone beam CT and conventional tomography for the detection of morphological temporomandiblar joint changes. 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