'Maturational Patient Report' supplied by GrowthTek clearly
assists and guides the clinician in formulating a well-timed treatment
plan. It is very important not to rely on chronologic age in
determining whether a functional or Herbst appliance will benefit
Functional and Herbst appliance treatment depends of the
correlation of treatment timing and good facial growth velocity,
particularly relative to mandibular repositioning. The general
theory behind these treatment modalities is that the occlusion is
disarticulated for significant periods of time, thereby allowing
the mandible to be 'free' to establish a more downward and
forward relationship within the face. This will not occur if
treatment is not timed well.
The following illustrations compare an example of less than ideal
timing of 13 months of functional appliance treatment with ideal
timing of 13 months of functional appliance treatment. The first
patient was treated at a very early adolescent period of develop-
ment ( SMI 1-2 ) which is characteristic of an accelerating but
relatively low mandibular growth rate. The second individual was
treated during a period of very high velocity mandibular growth
( SMI 4-7 ).
If Herbst and functional appliance treatment are not properly
timed relative to the individualized growth velocity patterns
of the patient, less than satisfactory results will be achieved.
Regardless of the patient's chronologic age, it is extremely
important to take into consideration the patient's maturational
stage and maturational level so that growth estimations and growth
timing can be estimated.
Note: Please refer to the other questions in this 'Clinical Applications'
section of this web site for specific clinical information regarding
maturational timing of treatment. Also refer to the 'Background
Information' section of this web site for additional information.
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