# Skeletodental and soft tissue changes following treatment with herbst and pendex appliances: a retrospective CBCT study

## TL;DR

This study compared the effects of Herbst and Pendex appliances on jaw and soft tissue changes in growing patients with Class II malocclusion.

## Contribution

The study provides a retrospective CBCT-based comparison of Herbst and Pendex appliances in Class II treatment.

## Key findings

- Both Herbst and Pendex groups showed similar mandibular dimensional changes.
- No significant differences were found in skeletal, dental, or soft tissue changes between the two groups.
- Skeletal vertical parameters remained stable in both groups.

## Abstract

To compare skeletodental and soft tissue changes in growing Class II patients treated with Herbst or Pendex appliances, followed by fixed edgewise appliances, using two-dimensional lateral cephalometric radiographs extracted from three-dimensional cone-beam computed tomography scans.

Forty-six patients were examined: 23 treated with Herbst (12.07 ± 1.49 years, 12 males/11 females) and 23 with Pendex (11.76 ± 1.18 years, 10 males/13 females). CBCT-derived lateral cephalograms were analyzed at T1 (initial), T2 (6 months post-Herbst removal or immediately post-Pendex removal), and T3 (final records after edgewise fixed appliance removal). Cephalometric analysis assessed skeletal, dental, and soft tissue changes. Repeated measures ANOVA analyzed within-group changes across the three time points, and t-tests were used to compare between-group differences at each time point and evaluate changes from T1 to T3.

From T1 to T3, the Herbst group exhibited a significant decrease in the SNA angle, a non-significant increase in SNB, and significant increases in mandibular dimensions, including total length, body length, corpus length, and ramus height. In contrast, the Pendex group demonstrated stable SNA values, a significant increase in SNB, and mandibular dimensional changes comparable to those observed in the Herbst group. Vertically, both groups remained stable with no significant differences in skeletal vertical parameters. Overall, no significant between-group differences were observed in skeletal, dental, or soft tissue parameters between T1 and T3.

We did not detect statistically significant differences in overall skeletal, dental, and soft tissue changes between the two groups.

The online version contains supplementary material available at 10.1007/s00784-025-06732-4.