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Hanks Telescopic Herbst


Appliance Purpose / Function:

Dr. Stephen Hanks favored the Herbst® appliance in his treatment planning, but wished to improve upon some problem areas. He replaced the two-piece tube and rod assembly with a one-piece telescoping arm which allows patients to open their mouth as wide as possible without causing the appliance to come apart. This design also eliminated the problem of painful ulcers caused by the rod rubbing against the superior aspect of the mandible. Dr. Hanks also replaced the traditional style pivots with a ball and socket joint which allows the patients a much greater range of lateral motion. When the cantilever design is being utilized, the Hanks Telescoping Herbst® utilizes an accessory that features a one-piece cantilever arm with a built-in threaded end. This eliminates the need for welding and soldering these parts in the lab.
Appliance Components:

  • Lingual Arch- .040 wire
  • Hanks Telescoping kit (Various sizes available)
  • Stainless steel crowns on upper and lower first molars

Suggested Materials:

  • Wire: Chromium Cobalt or Stainless-Steel wire
  • Solder: Silver Solder (Cadmium Free)

Appliance Fabrication Standards:

  • The universal nuts must be positioned on the buccal surface of the maxillary first molar bands/crowns with the arch wire tubes pointing towards the gingival. They must be positioned in the middle of the band/crown occlusal/gingival and slightly mesial to the middle of the band/crown mesial/distal
  • The soldered end of the cantilever arms must be positioned in the middle third of the band/crown on the mandibular first molars on the buccal side running the length of the tooth for strong solder joint. From the mesial side of the first molar, the cantilever arm must make a bayonet bend down and forward to the gingival margins of the posterior teeth for patient comfort. It must then extend in a mesial direction terminating in the area of the first bicuspids or primary molars with the threaded assembly pointing towards the occlusal
  • The telescoping arms must be chosen for best fit by measuring the distance from the universal nut on the first molar to the threaded portion of the cantilever arm. The arm must be positioned to the occlusal of the universal nut on the maxillary first molars
  • An .040 transpalatal arch must be soldered to the lingual surface of the maxillary first molars (unless otherwise specified by the Client)
  • An .040 lingual arch must be soldered to the lingual surface of the mandibular first molars (unless otherwise specified by the Client)
  • Shims must be added to the telescoping arms if needed to hold the position of the mandible indicated by the Client
  • The solder joints for the universal nuts and the cantilever arms must be heavy and cover the maximum possible surface area for strength

If Case is Banded: The reinforcement rings must be contoured to the circumference of the bands at the occlusal edges with a piece of .028 wire comprising the mesial portion and a piece of .036 wire comprising the distal portion. They must overlap on the buccal and lingual and the solder joints must be made in these locations.

If Case is Crowned: The models must be prepared by removing approximately 2mm of tissue below the gingival margin on the first molars in such a way to approximate the shape of the tooth and choosing the size crown that has the best possible fit. The gingival edges of the crowns may need to be reduced if the crown will not fully seat.