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Orthodontics & Craniofacial Research May 2019This narrative review surveys current research demonstrating how oral dysfunction can escalate into malocclusion, acquired craniofacial disorder and contribute to... (Review)
Review
UNLABELLED
This narrative review surveys current research demonstrating how oral dysfunction can escalate into malocclusion, acquired craniofacial disorder and contribute to generational dysfunction, disorder and disease.
INTRODUCTION
Baseline orthodontic consultations are generally recommended beginning age seven. However, the dysmorphic changes that result in malocclusion are often evident years earlier. Similarly, following orthodontic treatment, patients require permanent retention when the bite is not stable, and without such retention, the malocclusion can return.
SETTING AND POPULATION
Narrative review article including research on infants, children and adults.
MATERIALS AND METHODS
This review is a brief survey of the symptomology of orofacial myofunctional disorder and outlines 10 areas of oral function that impact occlusal and facial development: breastfeeding, airway obstruction, soft tissue restriction, mouth breathing, oral resting posture, oral habits, swallowing, chewing, the impact of orofacial myofunctional disorder (OMD) over time and maternal oral dysfunction on the developing foetus.
CONCLUSION
Malocclusions and their acquired craniofacial dysmorphology are the result of chronic oral dysfunction and OMD. In order to achieve long-term stability of the face, it is critical to understand the underlying pathologies contributing to malocclusion, open bite and hard palate collapse.
Topics: Adult; Child; Dental Occlusion; Humans; Infant; Malocclusion; Mastication; Mouth Breathing; Open Bite
PubMed: 31074141
DOI: 10.1111/ocr.12277 -
Progress in Orthodontics Dec 2016The treatment options for the early treatment of anterior open bite are still controversial. The aim of this study was to evaluate the actual available evidence on... (Review)
Review
BACKGROUND
The treatment options for the early treatment of anterior open bite are still controversial. The aim of this study was to evaluate the actual available evidence on treatments of anterior open bite in the mixed dentition in order to assess the effectiveness of the early treatment in reducing open bite, the most efficacious treatment strategy and the stability of the results.
MATERIALS AND METHODS
A literature survey was done on November 15, 2015, by means of appropriate Medical Subject Headings (MeSH) using the following databases: PubMed, EMBASE, Cochrane Library, LILACS, VHL, and WEB OF SCIENCE. Randomized clinical trials and studies with a control group (treated or untreated) were then selected by two authors. Trials including patients with syndromes or in the permanent dentition and studies concerning treatment with extractions, full-fixed appliances, or surgery were not considered. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion.
RESULTS
Two thousand five hundred sixty-nine studies about open bite were available; the search strategy selected 240 of them. Twenty-four articles have been judged suitably for the final review, and their relevant data were analyzed.
DISCUSSION
Although this review confirms the effectiveness of early treatment of open bite, particularly when no-compliance strategies are employed, meta-analysis was unfeasible due to lack of standardization, important methodological limitations, and shortcomings of the studies.
CONCLUSIONS
A more robust approach to trial design in terms of methodology and error analysis is needed. Besides, more studies with longer periods of follow-up are required.
Topics: Dentition, Mixed; Dentition, Permanent; Humans; Malocclusion; Meta-Analysis as Topic; Open Bite; Orthodontic Appliances; Orthodontic Appliances, Functional; Orthodontic Appliances, Removable; Orthodontics, Corrective; Orthopedic Procedures; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 27615261
DOI: 10.1186/s40510-016-0142-0 -
Dental Press Journal of Orthodontics 2018Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of...
OBJECTIVE
Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions.
METHODS
An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016.
RESULTS
Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids.
CONCLUSION
Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.
Topics: Databases, Factual; Dental Occlusion, Traumatic; Dentition, Mixed; Dentition, Permanent; Female; Geography; Global Health; Humans; Male; Malocclusion; Malocclusion, Angle Class I; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Open Bite; Population; Prevalence; Race Factors
PubMed: 30672991
DOI: 10.1590/2177-6709.23.6.40.e1-10.onl -
European Journal of Paediatric Dentistry Dec 2021The cause-effect relationship between anterior open bite and atypical swallowing, two frequently associated conditions, is currently not completely understood. These...
AIM
The cause-effect relationship between anterior open bite and atypical swallowing, two frequently associated conditions, is currently not completely understood. These conditions are often accompanied by speech disorders and represent a problem for both young patients and untreated adult patients. Treatment of these complex cases may be orthodontic, logopedic therapy or both. The purpose of this review is to compare the various types of treatment to determine their effectiveness in improving skeletal condition, normalisation of muscle activity, and temporal stability.
METHODS
The present systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA) guidelines. In order to find the most appropriate articles for inclusion, an electronic and manual search was performed using PubMed and The Cochrane Library on May 23, 2021. No language restrictions or time limits were applied. Only human studies describing cases of patients in the developmental stage of dentition, i.e., deciduous dentition or mixed dentition with an anterior open bite related to a type of swallowing with tongue interposition between the arches, undergoing three different types of treatment (orthodontic only, myofunctional/logopedic only, combined) were included.
CONCLUSION
The most effective treatment in cases of anterior open bite associated with atypical swallowing is a combination of the traditional orthodontic therapy and myofunctional therapy. Further studies are needed to devise an effective and universal logopaedic protocol to be followed in these cases.
Topics: Deglutition; Humans; Malocclusion; Myofunctional Therapy; Open Bite; Speech Therapy
PubMed: 35034464
DOI: 10.23804/ejpd.2021.22.04.5 -
Dental Press Journal of Orthodontics 2019Anterior open bite (AOB) is characterized by the lack of overlap or contact between maxillary and mandibular incisors, while the posterior teeth are in occlusion....
Anterior open bite (AOB) is characterized by the lack of overlap or contact between maxillary and mandibular incisors, while the posterior teeth are in occlusion. Correction of this malocclusion is challenging due to difficulties in determining and addressing the etiologic factors, and the high relapse rate. A multidisciplinary approach may be necessary, with participation of Orthodontics, Surgery and Speech Therapy, to achieve adequate esthetic and functional results for long term stability. The present paper discusses the treatment options for AOB, their advantages and implications.
Topics: Adult; Cephalometry; Esthetics, Dental; Humans; Incisor; Malocclusion; Maxilla; Open Bite; Orthodontics, Corrective
PubMed: 31721949
DOI: 10.1590/2177-6709.24.5.069-078.bbo -
Brazilian Dental Journal 2012Open bite has fascinated Orthodontics due to the difficulties regarding its treatment and maintenance of results. This anomaly has distinct characteristics that, in...
Open bite has fascinated Orthodontics due to the difficulties regarding its treatment and maintenance of results. This anomaly has distinct characteristics that, in addition to the complexity of multiple etiological factors, have aesthetic and functional consequences. Within this etiological context, several types of mechanics have been used in open bite treatment, such as palatal crib, orthopedic forces, occlusal adjustment, orthodontic camouflage with or without extraction, orthodontic intervention using mini-implants or mini-plates, and even orthognathic surgery. An accurate diagnosis and etiological determination are always the best guides to establish the objectives and the ideal treatment plan for such a malocclusion. This report describes two cases of open bite. At the end of the treatment, both patients had their canines and molars in Class I occlusion, normal overjet and overbite, and stability during the posttreatment period.
Topics: Adolescent; Cephalometry; Child; Deglutition Disorders; Extraoral Traction Appliances; Female; Follow-Up Studies; Humans; Male; Malocclusion, Angle Class III; Mandible; Mouth Breathing; Open Bite; Orthodontic Retainers; Palatal Expansion Technique; Patient Care Planning; Speech Disorders; Tongue Habits; Tooth Ankylosis; Tooth Eruption, Ectopic; Tooth Extraction; Tooth Movement Techniques; Treatment Outcome
PubMed: 23338275
DOI: 10.1590/s0103-64402012000600024 -
Progress in Orthodontics Mar 2018Non-nutritive sucking habits may adversely affect the orofacial complex. This systematic literature review aimed to find scientific evidence on the effect of pacifier... (Review)
Review
BACKGROUND
Non-nutritive sucking habits may adversely affect the orofacial complex. This systematic literature review aimed to find scientific evidence on the effect of pacifier sucking on orofacial structures.
METHODS
A search on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted to find all pertinent articles published from inception until February 2018, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the studies was evaluated using the risk of bias judgements in non-randomized studies of interventions (ROBINS-I).
RESULTS
Among the 2288 articles found, 17 articles met the selection criteria: seven prospective cohort studies, nine cross-sectional studies, and one randomized clinical trial. Using ROBINS-I, 12 studies were evaluated to have a serious overall risk of bias and five, a moderate one. These studies claimed a strong association between a pacifier sucking habit and the presence of an anterior open bite and posterior crossbite. Functional/orthodontic pacifiers were shown to cause significantly less open bites than the conventional ones.
CONCLUSIONS
High level of evidence of the effect of sucking habits on orofacial structures is missing. The available studies show severe or moderate risk of bias; hence, the findings in the literature need to be very carefully evaluated. There is moderate evidence that the use of pacifier is associated with anterior open bite and posterior crossbite, thus affecting the harmonious development of orofacial structures. Functional/orthodontic pacifiers reduce the prevalence of open bite when compared to the conventional ones, but evidence is needed concerning the effects on posterior crossbite. Well-designed randomized controlled trials are needed to further analyze the effects of functional/orthodontic and conventional pacifiers on orofacial structures.
Topics: Humans; Infant; Infant, Newborn; Malocclusion; Maxillofacial Development; Open Bite; Pacifiers; Sucking Behavior
PubMed: 29532184
DOI: 10.1186/s40510-018-0206-4 -
Progress in Orthodontics Aug 2020To evaluate the dental and skeletal effects that occur in the correction of anterior open bite with clear aligners.
OBJECTIVES
To evaluate the dental and skeletal effects that occur in the correction of anterior open bite with clear aligners.
MATERIALS AND METHOD
In this single-center retrospective study, the mechanism of anterior open bite closure using clear aligners (Invisalign, Align Technology, Santa Clara, CA, USA) was evaluated by cephalometric superimposition based on records of patients consecutively treated by a single, experienced Invisalign provider. Inclusion criteria consisted of anterior open bite (overbite < 0.5 mm), adult patients (18+) at the beginning of treatment, consecutive records, and good quality pre- and post-treatment records, where the required landmarks were clearly visible.
RESULTS
A total of 45 patients were included for data analysis with a mean age of 30.73 ± 8.0 years and initial open bite of - 1.21 ± 1.15 mm. During treatment, the upper incisors showed significant (p < 0.05) retraction [U1-SN'(°) = - 10.91 ± 6.95°], [U1-SN'(mm) = - 2.57 ± 1.75 mm] and extrusion [U1-SN'(mm) = 1.45 ± 0.89 mm]. The lower incisors also showed significant retraction [IMPA(°) = - 3.73 ± 4.91°), (ΔL1-MP' (mm) = - 1.08 ± 1.59] and extrusion (ΔL1-MP'(mm) = 0.53 ± 0.74). Regarding molar position, no significant changes were noted in the anteroposterior position of the upper [ΔU6-SN'(mm) = 0.01 ± 1.08 mm] and lower molar [ΔL6-MP'(mm) = 0.03 ± 0.87 mm]; however, there was a statistically significant intrusion of the upper [ΔU6-SN'(mm) = - 0.47 ± 0.59 mm] and lower molar [ΔL6-MP'(mm) = - 0.39 ± 0.76 mm].
CONCLUSION
Open bite closure with clear aligners occurred due to a combination of maxillary and mandibular incisor extrusion and maxillary and mandibular molar intrusion, with slight mandibular auto rotation. Significant retraction of maxillary and mandibular incisors was also observed with treatment. Clear aligners are effective in reducing/controlling the vertical dimension in open bite patients.
Topics: Adult; Cephalometry; Humans; Malocclusion, Angle Class II; Open Bite; Orthodontic Appliances, Removable; Retrospective Studies; Tooth Movement Techniques; Young Adult
PubMed: 32830306
DOI: 10.1186/s40510-020-00325-5 -
Progress in Orthodontics Sep 2020The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment.
METHODS
This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate.
RESULTS
Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars.
CONCLUSION
The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.
Topics: Cephalometry; Humans; Maxilla; Molar; Open Bite; Orthodontic Anchorage Procedures; Tooth Movement Techniques
PubMed: 32888097
DOI: 10.1186/s40510-020-00328-2 -
BMC Oral Health Aug 2018The development of primary dentition can be affected by oral sucking habits. Therefore, this study aims to investigate the association of nutritive and non-nutritive...
BACKGROUND
The development of primary dentition can be affected by oral sucking habits. Therefore, this study aims to investigate the association of nutritive and non-nutritive sucking habits with primary dentition development.
METHODS
One thousand one hundred and fourteen children aged 2 to 5 years old in Hong Kong were recruited in a cross-sectional study. Information on their nutritive (e.g. breastfeeding and bottle feeding) and non-nutritive sucking habits (e.g. pacifier use and thumb/digit sucking) was collected via questionnaires. The children's primary occlusions were examined in three dimensions.
RESULTS
Children who were breastfed for more than 6 months had a lower proportion of daily pacifier use (p < 0.05). Children who used pacifiers daily had a higher proportion of thumb/digit sucking (p < 0.05). Children who used pacifiers daily for more than one year had higher chances of developing an anterior open bite (p < 0.05) and a reduced overbite (p < 0.05). Those exhibiting daily thumb/digit sucking for more than one year had higher chances of developing Class II incisor and Class II canine relationships, an increased overjet and anterior open bite (p < 0.05).
CONCLUSION
Pure breastfeeding for more than 6 months is inversely associated with daily pacifier use and daily pacifier use is positively associated with daily thumb/digit sucking. Children with more than one year of daily pacifier use and thumb/digit sucking have higher chances of developing abnormal dental relationships in the sagittal (i.e. Class II incisor and Class II canine relationships and increased overjet) and vertical (i.e. anterior open bite) dimensions, respectively.
Topics: Bottle Feeding; Breast Feeding; Child, Preschool; Cross-Sectional Studies; Dental Occlusion; Female; Fingersucking; Hong Kong; Humans; Infant; Male; Malocclusion, Angle Class II; Pacifiers; Sucking Behavior; Surveys and Questionnaires
PubMed: 30134878
DOI: 10.1186/s12903-018-0610-7