H.B.O. WHAT IS IT?
A new design of mandibular advancement device based on the Herbst classic is presented, but with interocclusal hinges. This facilitates its use by patients and gives it robustness, making breakages practically disappear. In addition, it is made in semi adjustable articulator, allowing a gnathological occlusal function, especially in the literalities, to minimize any joint damage.
Figures 1 y 2. BASIC OUTLINE AND OCCLUSAL DETAIL
The elimination of the classic screws and their respective nuts not only reduces the economic cost of the device, but avoids protruding elements that bother the patient. The round configuration of the elements (2) and (3) corresponding to the hinges allows to avoid the rotation of one element with respect to another when they are connected to each other, contrary to what happens in the conventional ones, which being circular, allow the rotation of one element with respect to another and occupy more interocclusal space.
1) Upper and lower resin splints.
2) Upper tubular element of the hinge, round section.
3) Lower telescopic hinge rod, round section.
4) Tie pin for the telescopic rod (3) with the resin splint (1).
5) Carved occlusal housing in the splint (1) for the telescopic elements (2) and (3).
The Herbst device has proven to be one of the most effective methods of treating Class II malocclusions, although like all “functional” devices, its made of action remains controversial.
Experimental studies in growing animals show that condylar growth can be stimulated and the glenoid fossa can be remodeled. In humans, it increases mandibular length in the treatment of Class II malocclusions. More recently, other studies show an effective condylar growth, together with a change in its direction, and that the remodeling of both the condyle and the fossa contribute to this increase with little variation of the condyle-fossa relation.
Be that as it may, its effectiveness is undeniable. Our purpose is to present a new design of the mandibular advancement device that will help the clinician in his management by providing simple solutions to some known problems.
The novelty of this design consists of a transverse pin that is fixed in the respective splint without protruding from it. This pin passes through each end of the classic telescopic element through a hole. In this way, pin and hinge can rotate freely. (Figs. 1 y 2)
The elements of the hinge, both the tubular and rod-shank that slides telescopically inside improving the aesthetic appearance. The entire assembly of the device is carried out in a semi-adjustable articulator, so that the wide range of movements that it allows are directed according to the patient’s occlusal pattern.
Once made, the device comfortably in the mouth, and can be used as a removable or cemented device, as the case requires.
The mechanisms of action of this type of treatment have been and continue to be the subject of numerous studies.The conventional Herbst type devices had some problems that made them difficult to handle many times. The new design corrects many inconveniences, maintaining the effectiveness of the mandibular advance.
With it we have achieved the same results as with the classic design, but in a more comfortable way for the professional and for the patient: it is practically unbreakable with the usual use, it is more respectful with the occlusal function to allow wide lateralities, allows greater jaw expansions and it is more aesthetic.
This new design reduces sthe drawbacks derived from the screw-nut system located in the vestibular area. This is
- Optimize mandibular functional movements, maintaining an effective advance.
- Eliminate the problem of frequent breakages of the device in the area of the connecting screws.
- Improve the possibilities of expansion of the maxilla, with an amplitude of more than 15 mm.
- Simplify assembly.
- To improve the aesthetic aspect, since the elements of the hinge in the position of closing or of normal usecare formwork and, therefore, hidden from view.
NUEVO H.B.O. CON AVANCE MANDIBULAR PROGRESIVO
It serves for all types of patients.
Dolicofacial, open bite.
TOP AND BOTTOM FIXED H.B.O.
For non-collaborating patients.
H.B.O CLASS III
Mandibular prognathism, maxillary hypoplasia.
HBO CLASE III FLASH
H.B.O WITH BRACKETS
Possible combination of brackets with the H.B.O.
H.B.O. SUPERIOR FIXED.
LOWER REMOVABLE WITH FLASH SHIELD
For patients in adolescence with open bite and dolichos.
CLASSIC HBO WITH MIXED DENTITION
NEW DESIGN HBO CLASSIC COLOR BLUE.
HBO FIXED WITH VESTIBULAR ARCH
H.B.O. FIXED TO BANDS BY OCLUSAL
NEW SYSTEM OF ANCHORAGE IN THE STEMS FOR THE HIGHER FIXED H.B.O (THE SORES WERE FINISHED IN THE MOUTH DUE TO THE BALLS)