Hyperefficient orthodontic treatment using tandem mechanics.

This article presents an advanced and efficient noncompliance method of therapy referred to as tandem treatment. Tandem treatment was devised to harness the predictable orthodontic and orthopedic responses elicited by two proven fixed Class II correction devices, the pendulum and Herbst appliances. Tandem treatment involves two separate actions to resolve certain types of Class II malocclusions. First, the upper arch is expanded and the upper molars moved distally into a Class I relation. The pendulum appliance uses palatal and tooth-borne anchorage to move the upper molars distally. The pendulum is followed by a simplified version of the fixed Herbst appliance, which serves as anchorage to retract the remainder of the maxillary teeth to previously Class I positioned molars. This tandem of "pendex" appliance and fixed anchorage Herbst appliance has the ability to greatly improve treatment efficiency when used in appropriately selected patients. A case report is used to illustrate the treatment protocol.