The herbst or bite jumper appliance is by no means new to orthodontics. It was first developed by Dr. Emil Herbst in 1905 and reintroduced by Dr. hans Pancherz in the mid to late seventies. These designs usually incorporated bands or acrylic-type splints that were prone to breakage. However, the herbst bite jumper appliance has finally found its place in the last few years as technologyhas advance allowing the orthodontic industry to design a more easily fabricated, sturdier and comfortable appliance. Thus the crown/banded bite jumper appliances.
There are several advantages to the crown/banded bite jumper appliance over other designs.
- The patient's profile immediately looks better after the appliance has been inserted.
- Correction of Class II malocclusions are treated more efficiently making treatment much easier on the orthodontist, staff, patients and parents.
- Stainless steel crowns are easier to fit, stronger, less expensive, more retentive than
bands and the breakage is minimal.
- No removable parts, thus cooperation is therefore not an issue; treatment time is
predictable.
- Hygiene is not a Problem
- Orthodontic appliances can be worn in conjunction with the appliance.
There are many crown/banded bite jumper (herbst) designs that assist the clinician with
correction of different types of dental and skeletal problems. As the orthodontist becomes
comforable in his or her command of the appliance, the designs usually become more
sophisticated and modified to provide multifunctional applications based on the treatment
plan. Efficiency, profitability, and conistently predictable results are what the
The most common problem presented to the orthodontist is correction of skeletal Class II
malocclusions. In the past, most Class II's have been corrected with surgical procedures,
headgear and/or elastic therapy.
In most cases, the improper cite is caused by a lower jaw that is too far back in relation-
ship to the rest of the face. A good indicator of this type of malocclusion would be a case
where the upper lip is balancedwith the rest of the face by sliding the lower jaw forward,
thus creating a more pleasing profile.
When the patient is still growing, it is possible to accentuate the growth of the lower jaw to
catch up with the upper part of the face by using the bite jumper. The bite jumper is a
functional appliance because it postures the patient's lower jaw in a forward direction.
Over a periond of monthes, this forward posture of the lower jaw promotes growth in the same direction. Recent research has shown that this appliance has the ability to inhibit
maxillary anterior growth and produce an increase in mandibular length.
The crown and/or banded bite jumpers, because they are permanently attached to the
teeth for the duration of treatment, address the lack of success that functional appliances
have experienced in the past due to patient compliance. even though this appliance pre-
vents the lower jaw from moving backward, opening and closing movements still occur
easily and patients fully adjust to the appliance in about a week.
Bite jumpers are a multifunctional adjunct to skeletal Class II correction and work well with all different types of dental and skeletal Class II problems. The appliance can be
designed to accommodate upper and lower expansion, orthodontic appliances, intrusion
mechanics, molar protraction, distalization of upper molars, as well as be used unilaterally,
bilaterally and with asymmetric cases.
The following are indications for bite jumper treatment:
- The upper jaw is in good position and you want to advance the lower jaw.
optimum results can be achieved by controlling the amount and direction of
mandibular growth with the bite jumper.
- It is desirable to inhibit maxillary anterior growth and produce an increase in mandibular
length.
- Patient presents with an obtuse nasiolabial angle and the use of headgear of Class II
elastics would increase the angle, thus creating a less attractive face.
- Anterior open bites respond well to the appliance because the condyles come
down the eminence and tend to close the bite. This type of case is ideally treated in the mixed dentition state. When the skeletal Class II is corrected, the appliance
is removed and the upper deciduous teeth can be extraced. With the first molars
2-3 mm out of occlusion, closure of the ipen bite occurs quickly.
- Adult cases can achieve a good compromise Class II correction when lower jaw
surgery is not an option. While the result is mostly dental, some mesial migration
