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International Orthodontics Mar 2022To evaluate the effectiveness of the low-level laser therapy (LLLT) in accelerating the early treatment of the skeletal anterior open bite (AOB) and to evaluate the... (Randomized Controlled Trial)
Randomized Controlled Trial
Evaluation of the acceleration, skeletal and dentoalveolar effects of low-level laser therapy combined with fixed posterior bite blocks in children with skeletal anterior open bite: A three-arm randomised controlled trial.
OBJECTIVES
To evaluate the effectiveness of the low-level laser therapy (LLLT) in accelerating the early treatment of the skeletal anterior open bite (AOB) and to evaluate the associated skeletal and dentoalveolar changes.
MATERIALS AND METHODS
A three-arm, parallel-group, randomized controlled trial was conducted on 42 patients aged 8-10 years with skeletal AOB. Patients were randomly allocated to three groups: the fixed posterior bite block+low-level laser therapy (FPBB+LLLT) group; the fixed posterior bite block (FPBB) group; and the untreated control group (UCG) in a 1:1:1 allocation ratio. The LLLT dose in the FPBB+LLLT group was applied using 808-nm wavelength Ga-Al-As semiconductor laser device with the energy of 4-joules/point and irradiation time of 16 seconds/point. LLLT was applied in the first visit; then, it was applied on day 3, 7 and 14 of the first month. Afterwards, it was applied every 15 days until the end of the treatment. Lateral cephalometric images were taken at the beginning of the treatment (T0) and at the end of the active phase (T1). The primary outcome measures were the overall time needed to correct the AOB and the skeletal and dentoalveolar changes.
RESULTS
The correction of the AOB required significantly less mean time in the FPBB+LLLT group compared to the FPBB group (x̅=7.07, x̅=9.42 months, respectively; P=0.001). The mean upper first molar intrusion in the FPBB+LLLT group was 1.21mm and significantly greater than that of the FPBB group (0.82mm; P=0.018). However, there was a slight mean extrusion of the upper first molar in the UCG (0.32mm).
CONCLUSIONS
The overall time needed to correct the AOB was shorter in the FPBB+LLLT group. The LLLT appeared to be effective in accelerating orthodontic tooth movement. FPBB alone or LLLT were effective in the early treatment of anterior open bite (AOB). The two interventional groups produced similar dentoalveolar and skeletal changes; most of which were dentoalveolar in the correction of the anterior open bite.
Topics: Acceleration; Cephalometry; Child; Humans; Low-Level Light Therapy; Open Bite; Tooth Movement Techniques
PubMed: 34887236
DOI: 10.1016/j.ortho.2021.10.005 -
American Journal of Orthodontics and... Mar 2023Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by different authors. This meta-analysis aimed to evaluate the effect of bonded spurs, fixed and removable palatal cribs in the early treatment of AOB.
METHODS
A comprehensive electronic search was carried out through PubMed, Embase (via Ovid), MEDLINE (via Ovid), Cochrane Central Register of Controlled Trials, and Web of Science up to May 1, 2022. This meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The work was carried out by 2 reviewers in duplicate and independently, including electronic searching, data extracting, risk of bias assessment, quality of evidence grading, heterogeneity and statistical power analysis, and eligibility evaluation of the retrieved articles.
RESULTS
Four studies out of 181 articles were recruited in the meta-analysis after applying the inclusion and exclusion criteria. The results showed that bonded lingual spurs and fixed palatal crib or spurs produced similar overbite changes (mean difference, -0.32; 95% confidence interval, -1.06 to 0.43; P = 0.41; I = 27%; meta power = 0.099). Fixed palatal crib and removable palatal crib also exhibited comparable effects in correcting AOB (mean difference, -0.02; 95% confidence interval, -0.90 to 0.86; P = 0.96; I = 0%; meta power = 0.2182). The quality of evidence about these 2 outcomes assessed with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was low.
CONCLUSIONS
Bonded lingual spurs, fixed palatal crib or spurs, and removable palatal crib had similar effects in the early treatment of AOB. Because the number of included studies was limited and only the overbite changes before and after treatment were assessed, more clinical randomized controlled studies with longer follow-ups are needed to get more clinically significant advice.
Topics: Child; Humans; Open Bite; Overbite; Malocclusion, Angle Class II; Palate; Infant Equipment
PubMed: 36564317
DOI: 10.1016/j.ajodo.2022.10.017 -
The Journal of Clinical Pediatric... May 2022Genetic polymorphisms could explain the inter-individual differences in the oral health-related quality of life (OHRQoL) of children with anterior open bite (AOB).
UNLABELLED
Genetic polymorphisms could explain the inter-individual differences in the oral health-related quality of life (OHRQoL) of children with anterior open bite (AOB).
OBJECTIVE
To assess the impact of AOB on OHRQoL in children and to evaluate whether MTR (rs1805087), MTRR (rs1801394), TGFβ1 (rs1800469) and TNF-α (rs1799964, rs1799724 and rs1800629) genes are potential biomarkers for OHRQoL in children with AOB.
STUDY DESIGN
A cross-sectional study was performed with 173 children aged between 2-6 years. The Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS) was applied. Genetic polymorphisms were analyzed using real-time PCR. Mann-Whitney U-test and Chi-square were used.
RESULTS
The overall mean ECOHIS scores were 5.49 (SD= 5.72) and 3.45 (SD = 4.49) (p < 0.01) in the AOB and control groups, respectively. Children with the CC genotype of TNF-α (rs1799724) had a significantly higher psychological QoL level. The MTRR AA genotype group showed a lower QoL level in the child subscale (p = 0.006), function (p = 0.017), and psychological (p = 0.006) domains. There was no significant difference between OHRQoL and the genetic polymorphisms in MTR and TGFβ1.
CONCLUSIONS
Genetic polymorphisms in TNF-α and MTRR are associated with the impact on the OHRQoL in children with AOB.
Topics: Child; Child, Preschool; Cross-Sectional Studies; Ferredoxin-NADP Reductase; Humans; Open Bite; Oral Health; Polymorphism, Genetic; Quality of Life; Surveys and Questionnaires; Tumor Necrosis Factor-alpha
PubMed: 35830630
DOI: 10.17796/1053-4625-46.3.12 -
American Journal of Orthodontics and... Aug 2021
Topics: Cephalometry; Humans; Malocclusion, Angle Class II; Open Bite; Orthodontic Appliances, Removable
PubMed: 34332689
DOI: 10.1016/j.ajodo.2021.05.005 -
Cureus Dec 2022Objective The aim of the study was to evaluate skeletal, dentoalveolar, and soft tissue changes following early anterior open bite (AOB) treatment using a rapid molar...
Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial.
Objective The aim of the study was to evaluate skeletal, dentoalveolar, and soft tissue changes following early anterior open bite (AOB) treatment using a rapid molar intruder (RMI). Materials and methods A two-arm, parallel-group, randomized controlled trial was conducted on 40 patients aged 8-12 years with anterior open bites. They were randomly allocated to the RMI group and the untreated control group (UCG) with a 1:1 allocation ratio. At the beginning of the treatment (T1) and after nine months of treatment (T2), lateral cephalometric images were taken of each patient. The primary outcome measures were skeletal, dentoalveolar, and soft tissue changes. A two-sample t-test was used in the intergroup comparisons of the cephalometric measurement. Results The findings showed that the overbite increased significantly in the RMI group compared to the control group (= 4.44 mm, = 0.19 mm, respectively; p<0.001). A statistically significant intrusion of the upper and lower first molars was observed in the RMI group (= 2.9 mm, = 1.54 mm, respectively) compared to a slight extrusion in the control group. The differences between the two groups were significant (p<0.001). The SN: GoMe angle and the sum of Bjork decreased significantly in the RMI group compared to an increase observed in the control group. The differences between the two groups were significant (p<0.001). Conclusion The rapid molar intruder is an effective appliance for correcting anterior open bites in mixed dentition, inducing favorable skeletal, dentoalveolar, and soft tissue changes.
PubMed: 36570108
DOI: 10.7759/cureus.32826 -
Dentistry Journal May 2024The masticatory function of patients with skeletal anterior open bite (OPEN) is reported to be impaired compared with that of patients with normal occlusion (NORM). In...
The masticatory function of patients with skeletal anterior open bite (OPEN) is reported to be impaired compared with that of patients with normal occlusion (NORM). In this study, we compared brain blood flow (BBF) in patients with OPEN and NORM and investigated the factors related to BBF during mastication in patients with OPEN. The study included 17 individuals with NORM and 33 patients with OPEN. The following data were collected: number of occlusal contacts, jaw movement variables during mastication, and BBF measured with functional near-infrared spectroscopy during chewing. The number of occlusal contacts, maximum closing and opening speeds, closing angle, and vertical amplitude were smaller in the OPEN than in the NORM group. Interestingly, BBF increased less in the OPEN group. Correlation analysis revealed that several parameters, including number of occlusal contacts and closing angle, were correlated with changes in BBF during mastication. These results suggest that not only occlusion but also jaw movement variables and factors related to masticatory muscles contribute to the chewing-related increase in BBF. In conclusion, BBF increases less during mastication in patients with OPEN than in those with NORM. In addition, the higher increase in BBF is correlated with jaw movement. Together, we discovered that OPEN exhibits significant adverse effects not only on masticatory function but also on brain function.
PubMed: 38920862
DOI: 10.3390/dj12060161 -
Orthodontics & Craniofacial Research Aug 2024To describe the clinical and radiographic oro-dental characteristics of patients with pycnodysostosis (PDO).
OBJECTIVES
To describe the clinical and radiographic oro-dental characteristics of patients with pycnodysostosis (PDO).
MATERIALS & METHODS
A short interview and clinical examination of seven patients with PDO were performed as well as assessment of the temporomandibular joints and masticatory muscles using the diagnostic criteria for temporomandibular disorders, DC-TMD form. A full set of records were taken including photos and intraoral scan. Finally, existing cone beam computed tomography (CBCT) images and radiographs were also studied.
RESULTS
All patients presented with bimaxillary micrognathia, five had a convex profile, and two had a straight profile. In addition, posterior open bite, Angle Class III molar relation with accompanying anterior crossbite and a grooved median palate were common findings. No patient showed symptoms of temporomandibular disorder (TMD) apart from some clicking. Finally, the main radiographic findings were the obtuse mandibular angle, the frontal bossing, the elongation of the coronoid/condylar process and the presence of hypercementosis with obliterated pulp chambers.
CONCLUSION
The examined patients with PDO were characterized by dental crowding, malocclusion (anterior crossbite, posterior open bite), hypercementosis, obliterated pulp chambers and deviations in mandibular morphology. In conclusion, patients with PDO have a specific need for dental and orthodontic monitoring with focus on crowding and posterior open bite. The patients will benefit from a long-term orthodontic plan including extractions.
Topics: Humans; Female; Male; Cone-Beam Computed Tomography; Pycnodysostosis; Malocclusion; Adolescent; Child; Young Adult; Temporomandibular Joint Disorders; Adult
PubMed: 38532649
DOI: 10.1111/ocr.12782 -
Korean Journal of Orthodontics Mar 2022To evaluate clinical parameters and gingival crevicular fluid (GCF) cytokines in children with anterior open bite receiving passive orthodontic treatment with spurs.
OBJECTIVE
To evaluate clinical parameters and gingival crevicular fluid (GCF) cytokines in children with anterior open bite receiving passive orthodontic treatment with spurs.
METHODS
Twenty children with indications for interceptive orthodontic treatment, an anterior open bite, and good oral hygiene and periodontal health were included in this study. GCF samples were collected from the mandibular and maxillary central incisors before (baseline) and 24 hours and 7 days after spur bonding. Clinical and periodontal examinations and cytokine analyses were performed.
RESULTS
At 7 days after spur attachment, gingival bleeding in the mandibular group was increased relative to that in the maxillary group. Visible plaque was correlated with gingival bleeding at 7 days and the GCF volume at 24 hours after spur attachment. Compared with those at baseline, interleukin (IL)-8 levels in the maxillary group and IL-1β levels in both tooth groups increased at both 24 hours and 7 days and at 7 days, respectively. At 24 hours, IL-8, IL-1β, and IL-6 levels were higher in the maxillary group than in the mandibular group. Cytokine production was positively correlated with increased GCF volume, but not with gingival bleeding, visible plaque, or probing depth.
CONCLUSIONS
Although orthodontic treatment with spurs in children resulted in increased gingival bleeding around the mandibular incisors, IL levels were higher around the maxillary incisors and not correlated with periodontal parameters. Increased cytokine levels in GCF may be associated with the initial tooth movement during open bite correction with a passive orthodontic appliance in children.
PubMed: 35321953
DOI: 10.4041/kjod.2022.52.2.142 -
BMC Oral Health May 2021Due to the multifactorial aetiology and unpredictable long-term stability, skeletal anterior open bite (SAOB) is one of the most intractable conditions for...
BACKGROUND
Due to the multifactorial aetiology and unpredictable long-term stability, skeletal anterior open bite (SAOB) is one of the most intractable conditions for orthodontists. The abnormal orofacial myofunctional status (OMS) may be a major risk factor contributing to the development and relapse of SAOB. This study is aimed at evaluating the OMS and the efficacy of orofacial myofunctional therapy (OMT) alone for SAOB subjects.
METHODS
Eighteen adolescents with SAOB (4 males, 14 females; age: 12-18 years) and eighteen adolescents with normal occlusion (2 males, 16 females; age: 12-18 years) were selected. The electromyographic activity (EMGA) associated with mastication and closed mouth state was measured. Lateral cephalography was used to evaluate craniofacial morphology. Wilcoxon signed rank tests and t-tests were performed to evaluate myofunctional and morphological differences. Pearson or Spearman correlation analysis was used to investigate the correlations between EMGA and morphological characteristics. SAOB subjects were given OMT for 3 months, and the EMGA was compared between before and after OMT.
RESULTS
During rest, anterior temporalis activity (TAA) and mentalis muscle activity (MEA) increased in SAOB subjects, but TAA and masseter muscle activity (MMA) decreased in the intercuspal position (ICP); and upper orbicularis activity (UOA) and MEA significantly increased during lip sealing and swallowing (P < 0.05). Morphological evaluation revealed increases in the FMA, GoGn-SN, ANS-Me, N-Me, L1-MP, U6-PP, and L6-MP and decreases in the angle of the axis of the upper and lower central incisors and OB in SAOB subjects (P < 0.05). TAA, MMA and anterior digastric activity (DAA) in the ICP were negatively correlated with vertical height and positively correlated to incisor protrusion. MEA was positively correlated with vertical height and negatively correlated with incisor protrusion; and the UOA showed a similar correlation in ICP, during sealing lip and swallowing. After SAOB subjects received OMT, MEA during rest and TAA, MMA and DAA in the ICP increased, while UOA and MEA decreased (P < 0.05).
CONCLUSION
SAOB subjects showed abnormal OMS features including aberrant swallowing patterns and weak masticatory muscles, which were interrelated with the craniofacial dysmorphology features including a greater anterior facial height and incisor protrusion. Furthermore, OMT contributes to OMS harmonization, indicating its therapeutic prospect in SAOB.
Topics: Adolescent; Child; Electromyography; Female; Hepatitis C, Chronic; Humans; Male; Myofunctional Therapy; Open Bite; Temporal Muscle
PubMed: 33962610
DOI: 10.1186/s12903-021-01605-0 -
Orthodontics & Craniofacial Research Nov 2019The primary purpose of this study was to statistically evaluate age, ethnic and sex differences in the prevalence of clinically meaningful malocclusions among adults.
OBJECTIVE
The primary purpose of this study was to statistically evaluate age, ethnic and sex differences in the prevalence of clinically meaningful malocclusions among adults.
SETTING AND SAMPLE POPULATION
A random sample of 8804 untreated US adults between 17 and 46 years of age was selected from the Third National Health and Nutrition Examination Survey data.
MATERIALS & METHODS
Three ethnic (non-Hispanic White, non-Hispanic Black and Mexican Americans) and three age (17-26, 27-36 and 37-46 years) groups were evaluated. Subjects with and without clinically meaningful malocclusions were categorized based on the established cut-off values. Chi-square analyses were performed to determine differences in prevalence.
RESULTS
The prevalence of clinically meaningful mandibular incisor irregularity, overjet and overbite increased significantly (P < 0.05) with age, while posterior crossbite decreased. There were statistically significant ethnic differences in the prevalence of incisor irregularity, overbite, overjet, open bite and reverse overjet. Males had a significantly higher prevalence of clinically meaningful mandibular incisor irregularity, overbite, open bite and reverse overjet than females. One-third of US adults exhibited no clinically meaningful malocclusions.
CONCLUSIONS
There are age, ethnic and sex differences in the prevalence of clinically meaningful malocclusions that characterize approximately two-thirds of untreated US adults.
Topics: Adolescent; Adult; Female; Humans; Male; Malocclusion; Malocclusion, Angle Class II; Middle Aged; Nutrition Surveys; Overbite; Prevalence; Young Adult
PubMed: 31152488
DOI: 10.1111/ocr.12328