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Journal of Biological Regulators and... 2021Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior... (Review)
Review
Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior open bite. The skeletal open bite requires a more complex approach of treatment to reach function, aesthetics, and stability. The approaches vary depending on the causative factors and the age of patients. Treatment approaches for open bite patients differ when dealing with adults and growing patients. The aim of this descriptive review was to summarize the main existing treatment strategies for anterior open bite, from the noninvasive behavioural shaping to the orthodontic intrusion with skeletal anchorage.
Topics: Adult; Dentition, Mixed; Dentition, Permanent; Humans; Malocclusion; Open Bite
PubMed: 34281324
DOI: 10.23812/21-2supp1-27 -
British Dental Journal Feb 2015Orthognathic treatment is a process which involves orthodontics and maxillofacial surgery and is used to treat those dento-facial discrepancies which are outside the... (Review)
Review
Orthognathic treatment is a process which involves orthodontics and maxillofacial surgery and is used to treat those dento-facial discrepancies which are outside the scope of conventional orthodontic treatment, for example severe Class II or Class III problems, anterior open bites and facial asymmetries. Patients who present with these severe problems may encounter a wide range of different problems ranging from functional problems (for example, difficulties biting and chewing) to self-consciousness in a wide range of work and social situations. This paper discusses the possible indications for orthognathic treatment and looks at the risks and benefits of treatment. The treatment pathway is also described.
Topics: Esthetics, Dental; Facial Asymmetry; Humans; Malocclusion; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Open Bite; Orthodontics; Orthognathic Surgical Procedures; Patient Care Team; Quality of Life; Treatment Outcome
PubMed: 25686434
DOI: 10.1038/sj.bdj.2015.49 -
Prevalence of anterior open bite in children and adolescents: a systematic review and meta-analysis.European Archives of Paediatric... Jun 2022Anterior open bite is defined by the lack of incisal contact between the teeth in centric relation. The aim of this study was to determine the prevalence of anterior... (Meta-Analysis)
Meta-Analysis
PURPOSE
Anterior open bite is defined by the lack of incisal contact between the teeth in centric relation. The aim of this study was to determine the prevalence of anterior open in children and adolescents.
METHODS
This systematic review included a search in the databases: PubMed, Scopus, Web of Science, LILACS, Google Scholar, and ProQuest. The acronym PECOS was considered: (P) children and adolescents, (E) presence of anterior open bite, (C) not applicable, (O) prevalence, and (S) observational studies. The risk of bias assessment was carried out using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The prevalence meta-analyses were performed using MedCalc software. The certainty of the evidence was determined with the GRADE approach.
RESULTS
26 studies were included. Eleven studies were judged at low, seven at moderate, and eight at high risk of bias. The overall prevalence of anterior open bite was 16.52% (95% CI 12.34-21.17) in children and adolescents. The prevalence was 19.38% (95% CI 13.77-25.69) in South America. The prevalence of anterior open bite was 22.67% (95% CI 16.56-29.43) among females and 16.99% (95% CI 11.77-22.94) among males. The prevalence of anterior open bite was 18.84% (95% CI 13.88-24.38) in the primary dentition, and 14.26% (95% CI 7.67-22.46) in the mixed dentition. The overall certainty of the evidence was very low.
CONCLUSION
The overall prevalence of anterior open bite was 16.52% in children and adolescents aged 2-16 years. Giving the limitations of a prevalence meta-analysis, the extrapolation of the results should be cautious.
REGISTRATION NUMBER
CRD42020183162, 10 July 2020.
Topics: Adolescent; Child; Dentition, Mixed; Female; Humans; Male; Open Bite; Prevalence
PubMed: 34767190
DOI: 10.1007/s40368-021-00683-6 -
Progress in Orthodontics Nov 2023To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of... (Review)
Review
AIMS
To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events.
METHODS
A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal.
RESULTS
A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low.
CONCLUSIONS
Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.
Topics: Humans; Maxilla; Root Resorption; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Malocclusion; Open Bite; Molar
PubMed: 37953383
DOI: 10.1186/s40510-023-00490-3 -
Journal of the World Federation of... Aug 2022Routine alignment with fixed appliances and aligners is indeterminate mechanics because equilibrium equations are only applicable to two abutments: teeth, segments, or... (Review)
Review
Routine alignment with fixed appliances and aligners is indeterminate mechanics because equilibrium equations are only applicable to two abutments: teeth, segments, or arches. Orthodontists must depend on compliance and resilience of materials (archwires and aligners) for initial alignment. However, stabilized segments and arches are "large multirooted teeth" that can be moved with determinate mechanics using temporary skeletal anchorage devices. Temporary skeletal anchorage devices have advanced from retromolar implants and inter-radicular miniscrews to extra-alveolar bone screws placed in the basilar bone buccal to the first molars: mandibular buccal shelf and infrazygomatic crest. Extra-alveolar anchorage is determinate mechanics to move teeth, segments, and arches. Retraction and rotation of the lower arch reverses the etiology of Class III open bite malocclusion to correct severe skeletal dysplasia with no extractions or orthognathic surgery.
Topics: Biomechanical Phenomena; Cephalometry; Humans; Malocclusion, Angle Class III; Open Bite; Orthodontic Anchorage Procedures; Tooth Movement Techniques
PubMed: 35715332
DOI: 10.1016/j.ejwf.2022.04.001 -
American Journal of Orthodontics and... Sep 2020
Topics: Cephalometry; Humans; Mandibular Condyle; Open Bite
PubMed: 32862929
DOI: 10.1016/j.ajodo.2020.05.009 -
Journal of Orofacial Orthopedics =... May 2015The purpose of this work was to define and illustrate the skeletal morphology of open-bite patients against the background of sagittal jaw relationships on the basis of...
OBJECTIVES
The purpose of this work was to define and illustrate the skeletal morphology of open-bite patients against the background of sagittal jaw relationships on the basis of lateral cephalograms.
MATERIALS AND METHODS
Lateral cephalograms of 197 untreated adults were analyzed in dental imaging software (Onyx Ceph 3™; Image Instruments, Chemnitz, Germany). Four groups were formed based on vertical (Index scores) and sagittal (individualized ANB values) parameters. Ninety-nine patients were defined as the control group due to their neutral sagittal and vertical relationships. The remaining patients were found by their vertical relationships to represent open-bite cases and were divided by their sagittal relationships into three study groups: neutral (Class I, n = 34), distal (Class II, n = 26), and mesial (Class III, n = 38). A geometric morphometric approach was used to analyze the x,y-coordinates of 28 skeletal landmarks on each cephalogram. Relative size was captured based on centroid size (CS). The shape-determining factors in the groups were compared by permutation testing after Procrustes transformation, and intergroup differences were visualized in the form of thin-plate splines.
RESULTS
While size (CS) was significantly increased in the Class III group, the other two groups were not different from the control group. After Procrustes transformation, characteristic and invariably significant (p < 0.001) differences in shape were detected. Neutral (Class I) open bite involved compression in the mandibular ramus and the upper anterior facial third, including vertical expansion in the lower molar and anterior nasal spine areas. Mesial (Class III) open bite was associated with pronounced vertical and sagittal size reductions in the upper posterior segments and reduced lengths of the mandibular ramus. Distal (Class II) open bite involved expansion in the pterygoid area and compression in the mandibular ramus.
CONCLUSION
Open bite is not a homogeneous group. Our geometric techniques of morphometric analysis revealed typical patterns, thus, confirming the differences observed by traditional morphometry. True skeletal overdevelopment appears to be present only in open-bite cases having a mesial jaw relationship. All open-bite groups have in common that the mandibular ramus is compressed, but marked differences are seen in terms of vertical development of the maxilla. This differentiated view of open-bite cases should be taken into consideration during individual etiology assessment and treatment planning.
Topics: Adult; Cephalometry; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Jaw; Male; Open Bite; Radiography, Dental
PubMed: 25929714
DOI: 10.1007/s00056-015-0290-8 -
The Angle Orthodontist Jan 2022To investigate stability and satisfaction in adult anterior open bite (AOB) patients at least 9 months post-treatment, as well as patient and practitioner factors that...
OBJECTIVES
To investigate stability and satisfaction in adult anterior open bite (AOB) patients at least 9 months post-treatment, as well as patient and practitioner factors that may be associated with stability and satisfaction.
MATERIALS AND METHODS
Practitioners and their adult AOB patients were recruited through the National Dental Practice-Based Research Network. Data on patient and practitioner characteristics, treatment recommendations and factors were previously collected. Treatment stability was determined by assessing post-treatment intraoral photographs. Patient satisfaction was determined from post-treatment questionnaires. Treatment was categorized into aligners, fixed appliances, temporary anchorage devices, and orthognathic surgery. Extractions were also investigated. Retention type was categorized into vacuum-formed, Hawley-style, or bonded retainers, and regimens were classified as full-time or part-time wear.
RESULTS
Retention data collected from 112 patients had a mean post-treatment time of 1.21 years. There were no statistically significant differences in stability between treatment groups. Depending on whether a qualitative index or a millimetric measure was employed, stability ranged from 65% to 89%. Extractions and less initial lower incisor proclination were associated with higher stability in patients treated with fixed appliances only. High satisfaction was reported by patients at retention. There were no clear differences in stability or satisfaction among retention types or regimens.
CONCLUSIONS
The stability of adult AOB orthodontic treatment was high, regardless of treatment or retainer modality. Satisfaction in adult AOB patients was high, regardless of retention type or regimen.
Topics: Adult; Humans; Incisor; Malocclusion; Open Bite; Orthodontic Appliance Design; Orthodontic Appliances, Fixed; Orthodontic Retainers; Orthognathic Surgical Procedures; Vacuum
PubMed: 34587249
DOI: 10.2319/071221-549.1 -
Journal of Orofacial Orthopedics =... Jul 2016Presentation of different causes described in the literature for development of anterior apertognathia. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Presentation of different causes described in the literature for development of anterior apertognathia.
METHODS
A review about data referring to patients limited in their anterior tooth function through the positioning of their teeth has been performed. Electronic data bases, two libraries have been searched for information. Of the identified titles 357 articles and chapters were selected. 43 of these were considered.
RESULTS
Aetiology classifications are inconstant and author dependent, but mostly differentiated into genetic and environmental causes. Specifically named are: habit, tongue, airway obstruction, neuromuscular deficiency, trauma, rheumatoid disease, posture and posterior discrepancy.
CONCLUSIONS
Many different factors can be relevant for the development of apertognathia and have to be considered. Further research could help differentiating which of the partially contradictory statements are true.
Topics: Airway Obstruction; Evidence-Based Medicine; Fingersucking; Humans; Neuromuscular Diseases; Open Bite; Rheumatic Diseases; Temporomandibular Joint Disorders; Tongue Diseases
PubMed: 27098640
DOI: 10.1007/s00056-016-0029-1 -
Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial.The Angle Orthodontist Nov 2023To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion.
MATERIALS AND METHODS
Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis.
RESULTS
After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05).
CONCLUSIONS
Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.
Topics: Adult; Humans; Root Resorption; Overbite; Open Bite; Malocclusion, Angle Class II; Molar; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Orthodontic Appliances, Removable; Maxilla
PubMed: 37922387
DOI: 10.2319/010723-14.1