-
Cranio : the Journal of... Dec 2021The opinion on whether a patient with an anterior open bite should be treated surgically or not is controversial. These patients generally suffer from associated...
BACKGROUND
The opinion on whether a patient with an anterior open bite should be treated surgically or not is controversial. These patients generally suffer from associated discomfort due to their occlusal instability and musculoskeletal pain.
CLINICAL PRESENTATION
A 60-year-old woman visited the clinic with dental mobility of her upper central incisors as her chief complaint. She had a severe anterior open bite, with a history of continuous grinding and multiple dental restorations in poor condition. Additionally, she suffered neck pain with movement restrictions.
CONCLUSION
Dentists can evaluate and treat patients with an anterior open bite using this integrative model (physical therapy/dentistry) as a possible alternative as part of the treatment for anterior open bite patients.
PubMed: 34890299
DOI: 10.1080/08869634.2021.2014168 -
American Journal of Orthodontics and... Feb 2021This case report describes the treatment of a 16-year-old female patient with a skeletal open bite and temporomandibular dysfunction. Clear aligners and miniscrews were...
This case report describes the treatment of a 16-year-old female patient with a skeletal open bite and temporomandibular dysfunction. Clear aligners and miniscrews were used to control the occlusal plane and improve the skeletal problem. At the end of treatment, the mandible had rotated counterclockwise, allowing bite closure, upgrading dental and facial esthetics, and improving temporomandibular dysfunction.
Topics: Adolescent; Cephalometry; Female; Humans; Mandible; Open Bite; Orthodontic Appliances, Removable
PubMed: 33546827
DOI: 10.1016/j.ajodo.2019.07.020 -
BMJ Case Reports Aug 2020A 2-year-old boy was brought by his parents with complaints of difficulty in mouth opening for the past one and half years. He had difficulty in chewing and was...
A 2-year-old boy was brought by his parents with complaints of difficulty in mouth opening for the past one and half years. He had difficulty in chewing and was malnourished, with developing facial asymmetry. He was diagnosed with right side temporomandibular joint ankylosis. We planned for surgical removal of the ankylotic mass. But we modified the treatment protocol. Instead of doing coronoidectomy after aggressive excision of the ankylotic mass as advocated by Kaban, we did a 'coronoidoplasty' after aggressive excision of the ankylotic mass. Coronoidotomy or coronoidectomy is one of the rungs in the treatment ladder that is followed in surgical management of temporomandibular joint ankylosis. But one of the postoperative complications after coronoidectomy is the open bite. The difficulty to close the mouth becomes more pronounced when bilateral coronoidectomy is done. However, 'coronoidoplasty', as we have done for this patient retains the action of the temporalis muscle on the mandible in closing the mouth, yet removes the mechanical interference of the coronoid process. Postoperatively the patient was able to clench his teeth well, chew properly and there was no open bite.
Topics: Ankylosis; Child, Preschool; Humans; Male; Mandible; Orthognathic Surgical Procedures; Temporomandibular Joint Disorders
PubMed: 32843377
DOI: 10.1136/bcr-2020-235698 -
Progress in Orthodontics Apr 2022To produce a guide for dentists and orthodontists to determine orthodontic treatment need in borderline cases (dental health component DHC 3) and to compare views of... (Observational Study)
Observational Study
OBJECTIVE
To produce a guide for dentists and orthodontists to determine orthodontic treatment need in borderline cases (dental health component DHC 3) and to compare views of different panels of judges on treatment need.
MATERIALS AND METHODS
Prospective, observational study. Photographs of one hundred subjects displaying borderline occlusal traits (DHC3) were collected. Three panels of judges consisting of 25 orthodontists, 25 dentists and 25 lay persons assessed photographs based on orthodontic treatment need on aesthetic grounds.
RESULTS
Spearman's correlation coefficient showed no statistical difference between the panels of judges (p < 0.001). The judges identified a 'high need' for treatment on aesthetic grounds for those with anterior open bites and reverse overjets. Kappa analysis showed moderate intra-rater agreement for the orthodontic and dental panels of judges (k = 0.47 and 0.45, respectively) and fair agreement (k = 0.26) for the lay panel, highlighting the intrinsic difficulty of assessing borderline malocclusions.
CONCLUSION
There was no statistical difference in the way the orthodontic, dental and lay panels of judges perceived treatment need for DHC 3 cases. Anterior open bites and reverse overjets were predominantly found to be in high need of treatment by all panels of judges. A 'Guide to Borderline Orthodontic Need' (GBON) is proposed consisting of 8 photographs of subjects with borderline occlusal traits (DHC3) determined unambiguously by lay, dental and orthodontic panels as either 'needing' or 'not needing' orthodontic treatment on aesthetic grounds. It is anticipated that this will assist users to make judgments on aesthetic grounds on the need for treatment in borderline cases.
Topics: Esthetics, Dental; Humans; Malocclusion; Open Bite; Orthodontics, Corrective; Overbite; Prospective Studies
PubMed: 35434773
DOI: 10.1186/s40510-022-00407-6 -
FACE (Thousand Oaks, Calif.) Jun 2022Articulation problems are seen in 80-90% of dentofacial deformity (DFD) subjects compared with 5% of the general population, impacting communication and quality of life,...
INTRODUCTION
Articulation problems are seen in 80-90% of dentofacial deformity (DFD) subjects compared with 5% of the general population, impacting communication and quality of life, but the causal link is unclear. We hypothesize there are both qualitative (perceptual) and quantitative (spectral) differences in properties of stop (/t/ or /k/), fricative (/s/ or /∫/), and affricate (/t∫/) consonant sounds and that severity of anterior open bite (AOB) jaw disharmonies correlates with degree of speech abnormality.
METHODS
To test our hypotheses, surgical orthodontic records and audio recordings were collected from DFD patients (n=39 AOB, 62 controls). A speech pathologist evaluated subjects and recordings were analyzed using spectral moment analysis (SMA) to measure sound frequency distortions.
RESULTS
Perceptually, there is a higher prevalence of auditory and visual speech distortions in AOB DFD patients when compared to controls. Quantitatively, a significant (p<0.01) increase in the centroid frequency (M1) was seen in the /k/, /t/, /t∫/, and /s/ sounds of AOB subjects compared to the controls. Using linear regression, correlations between AOB skeletal severity and spectral distortion were found for /k/ and /t/ sounds.
CONCLUSIONS
A higher prevalence of qualitative distortion and significant quantitative spectral distortions in consonant sounds were seen in AOB patients compared to controls. Additionally, severity of skeletal AOB is correlated with degree of distortion for consonant sounds. These findings provide insight into how the surgical and/or orthodontic treatment of AOB may impact speech.
PubMed: 35903399
DOI: 10.1177/27325016221082229 -
F1000Research 2021This report describes a clinical case of unilateral condylar hyperplasia (CH) with unique, atypical morphology. An important feature of this report is the documentation...
This report describes a clinical case of unilateral condylar hyperplasia (CH) with unique, atypical morphology. An important feature of this report is the documentation of a series of clinical photographs of the patient, showing a gradual increase in facial asymmetry associated with the CH. The main symptom reported in this case was facial asymmetry. The main intraoral clinical features observed in the patient were contralateral crossbite and ipsilateral open bite associated with CH. Surgical reshaping of the condyle was the treatment plan for this case. The main take away point from this case is the importance of obtaining previous photographs of the patient at different ages during case diagnosis, which helps the clinician to determine the approximate time of commencement of CH. This case also highlights the imaging features of rarely observed atypical shape of the hyperplastic condyle.
Topics: Facial Asymmetry; Humans; Hyperplasia; Malocclusion; Mandibular Condyle
PubMed: 33564393
DOI: 10.12688/f1000research.48499.1 -
Journal of Advanced Pharmaceutical... Nov 2022Anterior open bite (AOB) is the insufficient vertical overlapping between the maxillary and mandibular anteriors when the teeth are in centric occlusion. The purpose of...
Anterior open bite (AOB) is the insufficient vertical overlapping between the maxillary and mandibular anteriors when the teeth are in centric occlusion. The purpose of this study was to determine the prevalence of AOB in children and adolescents who visited a private dental hospital. In this study, subjects aged between 16 and 18 years with AOB were included. Data about orthodontic examination of patients were taken from preentered dental records of the hospital. Data of patients with AOB regarding age, gender, and intraoral and extraoral features were collected from the case records of the subjects, and statistical analysis was performed (Chi-square test and nonparametric correlations). The prevalence percentage of open bite in the anteriors was 2.7%, with more prevalence in Class 1 subjects (81.5%). Subjects with AOB had competent lips (81.8%), straight nasolabial angle (86.8%), and shallow palatal vault (49.5%). AOB had no significant relationship with the type of malocclusion, palatal vault, and lip competency, according to the Chi-square test. AOB and the nasolabial angle had a significant association. Both acute and right-angled nasolabial angles were commonly seen in adolescent patients with AOB. In children and adolescents visiting a private dental hospital in Chennai, the prevalence of AOB was found to be 2.7%. A significant association was observed between AOB and nasolabial angle.
PubMed: 36643158
DOI: 10.4103/japtr.japtr_123_22 -
World Journal of Clinical Cases May 2023Temporomandibular joint (TMJ) disorders are closely related to high-angle and skeletal Class II malocclusion. Sometimes pathological changes in the mandibular condyle...
BACKGROUND
Temporomandibular joint (TMJ) disorders are closely related to high-angle and skeletal Class II malocclusion. Sometimes pathological changes in the mandibular condyle can cause open bite to occur after growth is complete.
CASE SUMMARY
This article is about the treatment of an adult male patient with a severe hyperdivergent skeletal Class II base, an unusual and gradually occurring open bite and an abnormal mandibular condyle anterior displacement. Because the patient refused surgery, four second molars with cavities and root canal therapy were extracted, and four mini-screws were used for intrusion of the posterior teeth. The treatment duration was 22 mo, and after the treatment, the open bite was corrected and the displaced mandibular condyles were seated back to the articular fossa as shown by cone-beam computed tomography (CBCT). Based on the patient's open bite history, the result of clinical examinations and CBCT comparisons, we believe it is possible that the occlusion interference was eliminated after the four second molars were extracted and the posterior teeth were intruded, and the patient's condyle spontaneously returned to its physiologic position. Finally, a normal overbite was established, and stable occlusion was achieved.
CONCLUSION
This case report suggested that identifying the cause of open bite is essential, and the TMJ factors for hyperdivergent skeletal Class II cases should be particularly examined. For these cases, intruding posterior teeth may place the condyle in a more appropriate position and provide an environment suitable for TMJ recovery.
PubMed: 37383903
DOI: 10.12998/wjcc.v11.i15.3599 -
Journal of Stomatology, Oral and... Nov 2021Treacher Collins Syndrome (TCS) is a genetic disorder with predominantly autosomal dominant inheritance, associated with different mutations in specific genes. This... (Review)
Review
Treacher Collins Syndrome (TCS) is a genetic disorder with predominantly autosomal dominant inheritance, associated with different mutations in specific genes. This review aimed to evaluate the facial, temporomandibular, zygomatic and bucco-dental phenotype in TCS individuals, and describe surgical and non-surgical solutions for each case in order to improve the quality of life of these individuals. A review of the literature on the craniofacial characteristics of the TCS was carried out, using the PICO strategy, and then a systematic search method was performed in Medline, Scopus, LILACS and SCIELO databases, identifying articles of impact and relevance until 10 June 2020, 240 articles were recovered and only 35 fulfilled the selection criteria. We found the main craniofacial and oral morphological characteristics of these individuals, and the possible functional alterations inducing repercussion in the stomatognathic apparatus. Among other characteristics, the most representative include hypoplasia in the zygomatic and mandibular complex, which can cause difficulty in breathing and feeding. In some cases, cleft palate and malocclusions such as anterior open bite may lead to Angle's Class II malocclusion, sometimes causing problems in the temporomandibular joint. In conclusion, individuals with TCS have specific craniofacial features including maxillary hypoplasia, altered orbital zones, mandibular retrognathia, and temporomandibular disorders. Oral deformities produce to a higher prevalence of caries and calculus formation because of poor hygiene due to the malformations present in these patients.
Topics: Cleft Palate; Face; Humans; Mandible; Mandibulofacial Dysostosis; Quality of Life
PubMed: 33166690
DOI: 10.1016/j.jormas.2020.10.011 -
The Angle Orthodontist Jan 2023To quantify dentoskeletal changes accompanying the use of extrusion arches during the treatment of anterior open bite (AOB) in adults.
OBJECTIVE
To quantify dentoskeletal changes accompanying the use of extrusion arches during the treatment of anterior open bite (AOB) in adults.
MATERIALS AND METHODS
A total of 23 adult patients with an AOB of -3.05 mm ± 1.27 mm were treated with upper and lower extrusion arches after the alignment phase. Lateral cephalograms were taken before placement of the extrusion arch, immediately after closure of the open bite (T2), and at the end of orthodontic treatment (T3). Data were statistically analyzed using repeated-measures analysis of variance and the Bonferroni post hoc test for pairwise comparisons (α = 0.05).
RESULTS
Successful closure of AOB, with an overall change in overbite of 4.73 ± 1.93 mm, was achieved in an average of 3.8 months and remained stable at T3. Upper and lower incisors were significantly extruded by 2.05 mm ± 0.72 mm and 2.54 mm ± 1.63 mm, respectively, and significantly retroclined by 6.36° ± 1.63° and 8.45° ± 3.83°, respectively, with a resultant increase in the interincisal angle of 12.80° ± 2.09°. Statistically significant intrusion and mesial tipping (P < .001) of the maxillary and mandibular first molars were observed at T2. Dentoskeletal changes remained stable at T3, except for a significant reduction of the mesial tipping of the maxillary and mandibular first molars.
CONCLUSIONS
The combined use of maxillary and mandibular extrusion arches resulted in significant favorable dentoskeletal changes that led to the successful closure of AOB during a short duration of treatment.
Topics: Humans; Adult; Open Bite; Cephalometry; Maxilla; Overbite; Malocclusion, Angle Class II; Tooth Movement Techniques
PubMed: 36066246
DOI: 10.2319/021922-155.1