Factors related to stability following the surgical correction of skeletal open bite (original) (raw)
Related papers
American Journal of Orthodontics and Dentofacial Orthopedics, 2007
This study was designed to evaluate the effectiveness of the open-bite bionator in growing subjects with increased vertical dimensions. Methods: The records of 20 subjects with high-angle skeletal relationships (MPA Ն25°) were examined. Cephalometric measurements were compared with those obtained from 23 sets of records of an untreated group matched according to age, sex, vertical skeletal relationships, and time intervals between records. Lateral cephalograms were analyzed before the start of treatment (mean age; 8.3 years) and after therapy and retention, with a mean period of observation of 2.5 years. Results: The treated group had a significantly smaller palatal plane-mandibular plane angle (Ϫ1.9°) and a greater overbite (ϩ1.5 mm) associated with a significantly smaller overjet when compared with the control group. Conclusions: Based on the analysis of this sample, early treatment of skeletal open bite with the open-bite bionator appears to produce a modest effect that mainly consists of significant improvement in intermaxillary divergence. No favorable effects on the extrusion of posterior teeth were found. (Am J Orthod Dentofacial Orthop 2007;132:595-8) d Research associate; Thomas M. Graber Visiting Scholar,
Orthodontic treatment of anterior open-bite malocclusion: Stability 10 years postretention
American Journal of Orthodontics and Dentofacial Orthopedics, 2010
Introduction: The postretention stability of open-bite treatment is a controversial topic in orthodontics. Methods: In this study, the lateral cephalometric radiographs of 64 patients treated with orthodontics alone were evaluated to determine the amount of postretention change. The mean postretention interval was 14 years. The sample was divided into 3 groups based on the amounts of pretreatment overbite: (1) the contact group (n 5 24), incisal overlap and incisal contact; (2) the overlap group (n 5 25), incisal overlap and no incisal contact; and (3) the open-bite group (n 5 15), no incisal overlap. The headfilms were digitized, and the values were analyzed. Results: The 3 groups reacted differently. During the postretention period, mean overbite deepened in all groups, with the contact group deepening significantly more than the open-bite group. Overjet increased significantly more in the open-bite group than in the contact group. Pretreatment overjet correlated mildly with postretention overjet relapse in the open-bite group. Conclusions: All 64 subjects had positive incisal overlap at the postretention recall. (Am J Orthod Dentofacial Orthop 2010;137:302.e1-302.e8)
The use of skeletal anchorage in open bite treatment: a cephalometric evaluation
The Angle orthodontist, 2004
The aims of the present study were to assess the effectiveness of skeletal anchorage for intrusion of maxillary posterior teeth, to correct open bite malocclusion, and to evaluate the usage of titanium miniplates for orthodontic anchorage. Anterior open bite is one of the most difficult malocclusions to treat orthodontically. Currently, surgical impaction of the maxillary posterior segment is considered to be the most effective treatment option in adult patients. Various studies have reported the use of implants as anchorage units at different sites of midfacial bones for orthodontic tooth movement. The zygomatic buttress area could be a valuable anchorage site to achieve intrusion of maxillary posterior teeth. Ten patients, 17 to 23 years old and characterized with an anterior open bite and excessive maxillary posterior growth, were included in this preliminary study. Titanium miniplates were fixed bilaterally to the zygomatic buttress area, and a force was applied bilaterally with...
Predominant dental and skeletal components associated with open-bite malocclusion
Journal of the World Federation of Orthodontists, 2014
Background: Various dentoskeletal factors can contribute to open-bite manifestation. This study aimed to compare dental and skeletal features in Iranian subjects with open bite and normal over bite and to determine the most frequent dental and skeletal contributing factors associated with open-bite malocclusion. Methods: In this cross-sectional study, dental and skeletal measurements were made on pretreatment lateral cephalograms and study models of the two groups, 80 patients with open-bite manifestation and 80 individuals with normal over bite. The subjects in both groups were aged 12 to 35 years. Data were subjected to t test using SPSS. Results: Our findings showed statistically significant differences in dental components, including decreased inclination of the lower incisors, greater clinical crown length in the lower first incisors and the upper first molars, and smaller curve of Spee measurement, in the open-bite group compared with the normal over-bite group. Inclination of the lower incisors showed the most prominent detected difference (P < 0.001). The two groups demonstrated the most significant differences in skeletal components, with increased basal and mandibular angles, total and lower anterior facial heights, and maxillary posterior alveolar and basal heights. Conclusions: Increased total anterior facial height, mandibular clockwise rotation, and increased maxillary posterior alveolar and basal heights were the predominant features of open-bite malocclusion influencing over bite. The inclination of the lower incisors was significantly decreased, indicating dentoalveolar adaptation to the backward rotation of the mandible.
Early Orthodontic Treatment of Skeletal Open-bite Malocclusion
2009
The aim of this study was a systematic review of the literature to assess the scientific evidence on the actual outcome of early treatments of open-bite malocclusions. A literature survey was done by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to July 2004 and used the MeSH, Medical Subject Headings. The following study types that reported data on the treatment effects included: randomized clinical trials (RCT), prospective and retrospective studies with concurrent untreated as well as normal controls, and clinical trials comparing at least two treatment strategies without any untreated or normal control group involved. The search strategy resulted in 1049 articles. After selection according to the inclusionary/exclusionary criteria, seven articles qualified for the final review analysis. No RCTs of early treatment of anterior open bite have been performed. Two controlled clinical trials of early anterior open bite have been performed, and these two studies indicated the effectiveness of treatment in the mixed dentition with headgears or functional appliances (or both). Most of the studies had serious problems of lack of power because of small sample size, bias and confounding variables, lack of method error analysis, blinding in measurements, and deficient or lack of statistical methods. Thus, the quality level of the studies was not sufficient enough to draw any evidence-based conclusions.
The Factors Affecting Long-Term Stability in Anterior Open-Bite Correction - A Systematic Review
Turkish Journal of Orthodontics
Objective: The present systemic review was conducted with the main purpose to evaluate the quantitative effects of orthognathic surgeries, extraction versus non-extraction treatment, and the type of malocclusion in the stability of anterior open-bite (AOB) correction over the long-term. Methods: The systematic search for studies was conducted through MEDLINE, CINAHL, EMBASE, Scopus, PsychINFO, various key journals, and review articles; November 30, 2016, was the last date for the search. The Quality Assessment Tool for Quantitative Studies was used to grade the methodological quality of the studies. Results: The present review included 14 studies. Stability of the corrected AOB ranged from 61.9% to 100%. The studies with orthognathic surgeries showed a stability of 70-100%. The studies without orthognathic surgeries showed the stability of 61.9-96.7%. All of the studies were retrospective. The mean change in AOB before (T1) and after treatment (T2-T1) was 0.1 mm to 6.93 mm and the mean change in overbite from T2 to T3 (T3-T2) was −0.06 mm to 2.5 mm. Conclusion: Studies with orthognathic surgeries presented with high amount of long-term stability in corrected AOB. No significant difference was noticed in relation to the type of malocclusion and extraction or non-extraction cases.
American Journal of Orthodontics and Dentofacial Orthopedics, 2011
Open bites are known to be difficult malocclusions to treat. Generally, with conventional edgewise treatment, incisor extrusion rather than molar intrusion is observed. Recently, the use of miniscrews as anchorage has markedly increased. In this study, orthodontic treatment outcomes after conventional edgewise treatment and implant-anchored treatment were investigated by cephalometric analysis and several occlusal indexes. In addition, the stability of these patients 2 years after the retention phase was also analyzed. Methods: Thirty adults (15 for nonimplant treatment [non-IA group] and 15 for implant-anchored treatment [IA group]) were our subjects. Cephalometric analysis, peer assessment rating, discrepancy index, and objective grading system were used. Results: From the cephalometric values in the non-IA group, open-bite patients were generally treated by extrusion of the maxillary and mandibular incisors that resulted in clockwise rotation of the mandibular plane angle. In the IA group, intrusion of the maxillary and mandibular molars that resulted in counterclockwise rotation was noted. Furthermore, in the IA group, the soft-tissue analysis showed decreases in the facial convexity and the inferior labial sulcus angle that resulted in the disappearance of incompetent lips. In the retention phase, extrusion of the mandibular molars was observed in the IA group. From the objective grading system evaluation, significant reductions of overbite in canines and premolars were observed in both groups. Furthermore, less stability was observed in the IA group compared with the non-IA group according to the total objective grading system score. Conclusions: Ideal occlusion can be achieved in adults with severe open bite with both conventional edgewise and implantanchored orthodontic treatment. However, absolute intrusion of the molars and improvement in esthetics might be achieved more effectively by using miniscrews as an anchorage device. In addition, since a significant amount of tooth movement occurs with miniscrews, careful attention is required during the retention phase. (Am J Orthod Dentofacial Orthop 2011;139:S60-8) S keletal open bite is known to be one of the most difficult malocclusions to treat in orthodontics. Since the cause of open bite is related to unfavorable growth pattern, 1-3 tongue posture and function, 4,5 habits, 6 and nasopharyngeal airway obstructions, 7,8 an orthopedic approach during the deciduous or mixed dentition periods might result in favorable treatment results. 4,9 In growing patients, high-pull headgear, 10,11 habit-breaking appliances, 12,13 bite-blocks, 14-16 and vertical chincups 17,18 are generally used to decrease
Comparison of 2 early treatment protocols for open-bite malocclusions
American Journal of Orthodontics and Dentofacial Orthopedics, 2007
The aim of this study was to compare the effects of the quad-helix/crib (Q-H/C) appliance and the open-bite bionator (OBB) in patients with open-bite malocclusions. The Q-H/C sample included 21 subjects, 15 girls and 6 boys. The average age for the Q-H/C group before treatment (T1) was 8.4 Ϯ 1.4 years, the mean age 1 year after active treatment (T2) was 10.9 Ϯ 1.6 years, and the mean duration of treatment was 2.6 years Ϯ 9 months. The OBB sample contained 20 subjects, 9 girls and 11 boys. The average ages were 8.3 years Ϯ 10 months at T1 and 10.8 Ϯ 1.5 years at T2. The mean duration of observation was 2.5 Ϯ 1.2 years. Lateral cephalograms were analyzed at T1 and T2. The T2 to T1 changes in the 2 groups were compared with a nonparametric test for independent samples (Mann-Whitney U test). The comparison between the 2 treatment protocols for skeletal open-bite malocclusion showed that the Q-H/C appliance is significantly more effective than the OBB for the improvement of overbite (ϩ1.9 mm) in association with extrusion (ϩ1.5 mm) and palatal inclination (ϩ2.9°) of the maxillary incisors.
Important Orthodontic Considerations in Preparation of Orthognathic Surgical Cases
Taiwanese Journal of Orthodontics, 2022
Nowadays some adult patients seeking for orthodontic treatment may present severe malocclusion associated with pronounced skeletal discrepancies. Accordingly, thorough consideration and planning would be beneficial for the patient by the combined efforts of orthodontic and orthognathic approaches. This review reiterated the genetic impact on the growth velocity of the jaw with age in Class III malocclusion, and outlined the treatment protocol for the steps including the initial evaluation, the diagnosis, and the alignment of the teeth and dental arches before and after surgical correction. Specifically, emphasis is addressed on how to obtain records of jaw relationship in centric relation (CR) position. Moreover, the combined efforts in correcting the dental and skeletal Class II jaw discrepancy were defined and discussed.