The MIO is a measurement Specialty Appliances uses to size MiniScopes for each patient. The wrong sized MiniScope may allow the patient to pull off the lower crowns because they are not able to fully achieve their MIO. If Specialty Appliances has the MIO, we can provide you with the correct size MiniScope and the patient will not be able to dislodge their appliance.
The MIO is the measurement of the distance from the upper to the lower incisal edges with the patient opening to the limit of their comfortable, pain free range. Add the amount of overbite to that dimension for an accurate MIO measurement.
What warrants starting a patient on Herbst treatment at an earlier age?
Phase I treatment is justified when a patient has a severe class II malocclusion or the patient experiences ridicule at school. The Herbst will usually change the patients’ profile immediately and they will look more natural to their peers.
What is the average age you start a patient in Phase II treatment?
Patients are ideally started in Herbst treatment between the ages of 11 and 12. This allows for the maximum effect of the Herbst during their growth spurt. The age can vary depending on the maturity of the patient.
What procedure must you follow when you add an expander to the upper Herbst Appliance?
If patients are in a posterior cross-bite, the upper member of the Herbst appliance will often have to be expanded before the mechanism is attached. However, the new telescoping mechanisms with the AppleCore screws allow you to insert the complete appliance due to the flexibility they offer.
What is the standard advancement you initially place a patient in for treatment?
We normally will advance a Class II or a Class II Division II patient to an end to end advancement. This is only done if the distance is less than 8 millimeters. A Class II Division I patient will be advanced to Class I molars. However, your prescribed advancement will overrule our standards.
How do I know if the condyle is centered if I do not have a tomogram?
An easy way to determine if the condyle is centered is to remove the Herbst mechanism and wait for one month. If the patient has relapsed, simply reattach the mechanism and continue treatment for 3 months.
Do you always add archwire tubes to the upper and lower arch?
We add archwire tubes to the upper and lower arch on 90% of all Herbst appliances we construct. This allows the clinician to tie the upper arch together to limit the “headgear effect” and level the lower arch during treatment.
"Clear Image Aligners are the perfect solution in our practice for those in-between cases when you need to tweak one to six anteriors and Invisalign would be overkill. Our patients love that we have an invisible solution for their alignment..."