A prospective clinical trial of the effects produced by the extrusion arch in the treatment of anterior open bite

Abstract Aim To evaluate the maxillary dentition effects of the extrusion arch for anterior open bite (AOB) correction in mixed dentition patients. Materials and methods Fourteen subjects with an initial mean age of 9.17 ± 1.03 years presenting with dentoalveolar AOB (mean − 1.28 ± 1.46 mm) and normal facial pattern (FMA = 25.76°) were treated with an extrusion arch. The mean treatment period was 7.79 ± 2.58 months. Lateral cephalograms and dental models were taken before (T0) and after the correction of AOB (T1). Data were analyzed using paired t test to evaluate differences between T0 and T1. For all tests, a significance level of P < .05 was used. Results All patients achieved positive overbite at T1, with a mean increase of 3.07 mm. The maxillary incisors extruded 1.94 mm. Retroclination of the maxillary incisors (− 6.15°) and an increase in the interincisal angle (5.57°) were observed. There was a significant decrease in the distance between the incisal edge of the maxillary incisors and the molars (− 2.21 mm). There was significant mesial tipping of the maxillary molar (− 11.49°). Significant reductions of overjet (− 1.65 mm), arch perimeter (− 3.02 mm), and arch length (− 2.23 mm) were noted. The transverse maxillary intermolar distance did not change significantly. Conclusions The use of a maxillary extrusion arch was effective in the treatment of AOB. Overbite increased due to incisor extrusion, as well as retroinclination and overjet reduction. However, side effects, such as mesial molar tipping and decreases in arch perimeter and length might occur.

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Response of the maxillary dentition to a statically determinate one-couple system with tip-back mechanics: A prospective clinical trial

The Angle Orthodontist ◽

10.2319/012815-68.1 ◽

2015 ◽

Vol 86 (1) ◽

pp. 32-38 ◽

Cited By ~ 2

Author(s):

Nandakumar Janakiraman ◽

Pawandeep Gill ◽

Madhur Upadhyay ◽

Ravindra Nanda ◽

Flavio Uribe

Keyword(s):

Couple System ◽

Root Apex ◽

Maxillary Molars ◽

Angular Change ◽

Signed Rank ◽

Lateral Cephalograms ◽

Maxillary Molar ◽

Maxillary Incisors ◽

Root Movement ◽

Maxillary Dentition

ABSTRACT Objective: To quantify the effects of tip-back mechanics on the maxillary first molars and incisors. Materials and Methods: Sixteen subjects with Class II end-on malocclusion were treated with an intrusion arch to achieve distalization of the maxillary molar through tip-back mechanics. Lateral cephalograms were taken prior to molar tip-back (T1), after molar tip-back (T2), and after molar root uprighting (T3). Data were analyzed using the Friedman’s and Wilcoxon signed rank tests to evaluate differences in time points (P ≤ .016). Results: The maxillary first molar distalized 1.53 mm (P = .001) with 6.65° (P = .001) of distal tipping and 0.86 mm (P = .001) of extrusion at T2. Minor relapse of the first molar (mesial direction) was seen at T3. The maxillary incisors flared labially 0.4 mm, and the incisor root apex moved palatally 1.19 mm (P = .005) at T2. At T3, the incisor root apex moved palatally 1.5 mm (P = .003) from T1. An angular change from T1 of 3.31° (P = .008) and 3.53° (P = .014) was seen at T2 and T3, respectively, as a result of palatal root movement of the maxillary incisors. Conclusions: A significant amount of distalization of maxillary molars was attained at the crown level with tip-back mechanics. Palatal root angulation change was significant in the incisors with minimal anteroposterior movement of the incisal edge.

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The correlation between malocclusions and morphofunctional aspects: analysis of patients aged from 7 to 12 years old

Brazilian Dental Science ◽

10.14295/bds.2016.v19i4.1304 ◽

2016 ◽

Vol 19 (4) ◽

pp. 90

Author(s):

Regiane Almeida Da Silva ◽

Renato Morales Jóias ◽

Erika Josgrilberg ◽

Sigmar De Mello Rode ◽

Luiz Renato Paranhos ◽

...

Keyword(s):

Statistical Tests ◽

Class Ii ◽

Open Bite ◽

Mixed Dentition ◽

Class I ◽

Class Iii ◽

Anterior Open Bite ◽

Chi Square ◽

Significance Level ◽

Important Correlation

Objective: To classify the malocclusions and their occlusal and morphofunctional aspects in order to establish possible correlations. Material and Methods: The present observational and analytical study was performed within 432 dental records of patients. The patients were aged between 7 and 12 years old (228 males and 204 females) from an Educational Institute in the state of São Paulo, Brazil. The data regarding the malocclusions and the related associations underwent parametric statistical tests for quantitative and qualitative analysis (ANOVA, Tukey test and Chi-square) considering the significance level at 5%. Results: Most of the patients had permanent dentition (58.6%), followed by mixed dentition. Angle’s Class II malocclusion was the most prevalent (67.2%), followed by Class I and III. Overbite and anterior open bite represented, respectively, 47% and 7.2% of the vertical discrepancies. The average overbite was 3.08mm, while the average overjet was 4.67mm. Approximately 43,1% of the sample presented moth breathing. Atypical swallowing reached 78.7% of the patients. Statistically significant correlations were observed associating Angle’s Class III malocclusion with anterior cross bite and bilateral posterior cross bite; as well as between Angle’s Class II with overbite, and Angle’s Class I with overbite and atypical swallowing. A correlation was observed between atypical swallowing; the use of pacifiers; and predominant mouth breathing (p<0.001). Conclusion: An important correlation was found between the type of malocclusions and the morphofunctional aspects of occlusion in patients aged from 7 to 12 years old, indicating the need for immediate intervention once the diagnosis is established. Keywords: Applications of epidemiology, Malocclusion, Child.

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Prediction of mandibular movement and its center of rotation for nonsurgical correction of anterior open bite via maxillary molar intrusion

The Angle Orthodontist ◽

10.2319/102317-714.1 ◽

2018 ◽

Vol 88 (5) ◽

pp. 538-544 ◽

Cited By ~ 6

Author(s):

Kyunam Kim ◽

Kwangchul Choy ◽

Young-Chel Park ◽

Seo Yeon Han ◽

Heekyu Jung ◽

...

Keyword(s):

Linear Regression Analysis ◽

Open Bite ◽

Reference Plane ◽

Mandibular Movement ◽

Anterior Open Bite ◽

Counterclockwise Rotation ◽

Molar Intrusion ◽

Lateral Cephalograms ◽

Maxillary Molar ◽

The Relationship

ABSTRACT Objectives: To evaluate quantitatively the relationship between molar intrusion (change [Δ] maxillary first molar [U6]–palatal plane [PP]) and changes in vertical and sagittal cephalometric parameters and to determine the center of mandibular autorotation. Materials and Methods: Twenty-one patients diagnosed with anterior open bite and successfully treated with molar intrusion (overbite [OB] > 0 mm) were retrospectively enrolled. Lateral cephalograms taken before and after molar intrusion were used to measure changes in vertical and sagittal cephalometric parameters. The center of mandibular autorotation was calculated by measuring displacement of gonion (Go) and pogonion (Pog). Paired t-tests were used to compare variables, and linear regression analysis was used to examine the relationship between ΔU6-PP and other variables. Results: The mandible exhibited counterclockwise rotation after maxillary molar intrusion, which led to closure of anterior open bite. Strong linear relationships, in descending order, between ΔU6-PP and ΔOB, Δanterior facial height (AFH), Δvertical reference plane (Pog), and Δsella-nasion to Go-menton (SN-GoMe), were observed. When the maxillary molar was intruded 1 mm, OB increased by 2.6 mm, AFH decreased by 1.7 mm, Pog moved forward by 2.3 mm, and SN-GoMe decreased by 2°. The center of mandibular autorotation was located 7.4 mm behind and 16.9 mm below condylion after molar intrusion. Conclusions: The mandible exhibited counterclockwise rotation after maxillary molar intrusion; the center of mandibular autorotation was located behind and below condylion with individual variations.

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Anterior open bite: cephalometric evaluation of the dental pattern

Brazilian Dental Journal ◽

10.1590/s0103-64402006000100015 ◽

2006 ◽

Vol 17 (1) ◽

pp. 68-70 ◽

Cited By ~ 2

Author(s):

Adriana Sasso Stuani ◽

Andréa Sasso Stuani ◽

Maria Bernadete Sasso Stuani ◽

Maria da Conceição Pereira Saraiva ◽

Mírian Aiko Nakane Matsumoto

Keyword(s):

Open Bite ◽

Occlusal Plane ◽

Anterior Open Bite ◽

Panoramic Radiographs ◽

Lateral Cephalograms ◽

Significant Difference ◽

Dental Origin ◽

Dental Pattern ◽

Mandibular Incisors

The purpose of this study was to compare the dental pattern of patients with anterior open bite malocclusion to that of individuals with normal overbite by utilization of lateral cephalograms, panoramic radiographs and study casts. The findings showed that there was no significant difference in the inclination of the occlusal plane (SN.PlO) and position of the maxillary and mandibular incisors (1-NA, 1-NB) between both groups of individuals; but the angles of inclination of the maxillary and mandibular incisors (1.1, 1.NA and 1.NB) differed statistically between patients with anterior open bite of the individuals that presented normal overbite, which suggests that the anterior open bite may be of dental origin.

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Skeletal Response to Maxillary Protraction in Patients with Cleft Lip and Palate before Age 10 Years

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1994_031_0295_srtmpi_2.3.co_2 ◽

1994 ◽

Vol 31 (4) ◽

pp. 295-308 ◽

Cited By ~ 19

Author(s):

Rolf S. Tindlund

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Poor Response ◽

Mixed Dentition ◽

Forward Movement ◽

Maxillary Protraction ◽

Face Height ◽

Lateral Cephalograms ◽

Before And After ◽

Maxillary Dentition

Over the last 15 years, cleft lip and palate (CLP) patients with maxillary deficiency in the care of the Bergen CLP Team have received interceptive orthopedic treatment to correct anterior and posterior crossbites during the deciduous and mixed dentition periods. The present study comprises 72 subjects of various cleft types with anterior crossbite, treated to an acceptable positive overjet by maxillary protraction using a facial mask (Delaire). Lateral cephalograms were taken immediately before and after the active treatment periods. Individuals exhibiting a favorable (fair) skeletal response to the protraction were compared with those who revealed little, (poor) skeletal response. Two cephalometric variables were chosen for the evaluation of the sagittal skeletal treatment changes: (1) the sagittal maxillomandibular change (change of angle ss-n-sm [ANB]); and (2) the forward movement of the maxilla (change of distance NSP-maxp), where maxp (maxillary point) represents the anterior contour of maxilla and NSP is the perpendicular to the naslon-sella-line (NSL) through sella. A numerical change greater than or equal to the value 1.5 (degrees or mm, respectively) was classified as fair versus poor response revealing a change less than 1.5. Fair-response (favorable response) of sagittal maxillomandibular change was found in 63 % of the cases (mean increase of angle ANB was 3.3 degrees), more often when protraction started early. The length of maxilla was increased, the skeletal maxilla was moved forward 1.8 mm, the upper dentition advanced 3.6 mm, the occlusal line was clockwise rotated, and the anterior face height was increased. Similarly, fair-response of forward movement of maxilla was found in 44% of the cases (mean increase of distance NSP-maxp was 2.4 mm), more often when protraction was started early and after long treatment duration. The maxillary prognathism increased 1.8 degrees, the angle ANB increased 3 degrees, the length of maxilla increased 1.5 mm, and the upper dentition was advanced 3.7 mm. The anterior face height increased with counterclockwise rotation of the nasal line, whereas the occlusal line was clockwise rotated. A paired fair-response of both skeletal maxillomandibular change and skeletal forward movement of maxilla was found in 35% of the cases. During protraction the mean increase of maxillary prognathism was 2.1 degrees, the maxilla moved forward 3.1 mm, the maxillary dentition advanced 4.3 mm, the maxillary length increased 1.9 mm, the ANB angle increased 3.7 degrees, and the lower anterior facial height increased 3.4 mm.

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Comparison of Treatment Effects with Modified C-Palatal Plates vs Greenfield Molar Distalizer Appliances in Adolescents

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-44.3.12 ◽

2020 ◽

Vol 44 (3) ◽

pp. 202-208

Author(s):

Mohammed Alfaifi ◽

Jae Hyun Park ◽

Kiyoshi Tai ◽

Ja Hyeong Ku ◽

Nikhilesh R Vaid ◽

...

Keyword(s):

Treatment Effects ◽

Group Differences ◽

Class Ii Malocclusion ◽

Molar Distalization ◽

Skeletal Changes ◽

Lateral Cephalograms ◽

Significant Difference ◽

Maxillary Molar ◽

The Mean ◽

Maxillary Incisors

Objectives: The aim of study was to evaluate skeletodental and soft tissue treatment effects and the amount of maxillary molar distalization with modified C-palatal plates vs. Greenfield molar distalizer appliances in adolescents. Study design: The samples consisted of pre- and posttreatment lateral cephalograms collected from 39 patients with Class II malocclusion. The MCPP group was comprised of 21 patients (mean age: 11.7 ± 1.3 years) treated with MCPP appliances while the GMD group included 18 patients (mean age: 11.2 ± 0.9 years) treated with GMD. Fixed orthodontic treatment started with the distalization process in both groups. From each cephalograpm, twenty-nine variables were measured for analysis and then the two groups were compared. Descriptive statistics, a paired t-test, and multivariate analysis of variance were performed to compare the treatment effects within and between the groups. Results: There was significant treatmentrelated change in the sagittal position of the maxilla and the mandible within each group. However, there were no statistically significant inter-group differences. The mean maxillary first molar distalization was 3.96 mm in the MCPP group vs. 2.85 mm in the GMD group. Both groups showed minimal distal tipping, but the maxillary incisors were significantly extruded by 3.04 ± 0.89 mm (P < .001) in GMD group. There was no significant difference in treatment duration between the groups. Conclusions: The maxillary first molars of both the MCPP and GMD groups were effectively distalized and there were significant skeletal changes in the maxilla. However, the maxillary incisors were significantly extruded in the GMD group.

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Noninvasive and Multidisciplinary Approach to the Functional and Esthetic Rehabilitation of Amelogenesis Imperfecta: A Pediatric Case Report

Case Reports in Dentistry ◽

10.1155/2014/127175 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Juliana Feltrin de Souza ◽

Camila Maria Bullio Fragelli ◽

Marco Aurélio Benini Paschoal ◽

Edson Alves Campos ◽

Leonardo Fernandes Cunha ◽

...

Keyword(s):

Case Report ◽

Composite Resin ◽

Preventive Treatment ◽

Open Bite ◽

Amelogenesis Imperfecta ◽

Mixed Dentition ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Anterior Teeth

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth.Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed .Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

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Relationship between facial morphology, anterior open bite and non-nutritive sucking habits during the primary dentition stage

Dental Press Journal of Orthodontics ◽

10.1590/2176-9451.19.3.108-113.oar ◽

2014 ◽

Vol 19 (3) ◽

pp. 108-113 ◽

Cited By ~ 5

Author(s):

Melissa Proença Nogueira Fialho ◽

Célia Regina Maio Pinzan-Vercelino ◽

Rodrigo Proença Nogueira ◽

Júlio de Araújo Gurgel

Keyword(s):

Significant Relationship ◽

Primary Dentition ◽

Open Bite ◽

Facial Morphology ◽

Anterior Open Bite ◽

Legal Guardians ◽

Nutritive Sucking ◽

Potential Association ◽

Facial Pattern ◽

Stage Play

INTRODUCTION: Non-nutritive sucking habits (NNSHs) can cause occlusal alterations, including anterior open bite (AOB). However, not all patients develop this malocclusion. Therefore, the emergence of AOB does not depend on deleterious habits, only. OBJECTIVE: Investigate a potential association between non-nutritive sucking habits (NNSHs), anterior open bite (AOB) and facial morphology (FM). METHODS: 176 children in the primary dentition stage were selected. Intra and extraoral clinical examinations were performed and the children's legal guardians were asked to respond to a questionnaire comprising issues related to non-nutritive sucking habits (NNSHs). RESULTS: A statistically significant relationship was found between non-nutritive sucking habits (NNSHs) and anterior open bite (AOB). However, no association was found between these factors and children's facial morphology (FM). CONCLUSIONS: Non-nutritive sucking habits (NNSHs) during the primary dentition stage play a key role in determining anterior open bite (AOB) malocclusion regardless of patient's morphological facial pattern (FM).

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Effects of palatal crib and bonded spurs in early treatment of anterior open bite: A prospective randomized clinical study

The Angle Orthodontist ◽

10.2319/031815-170.1 ◽

2015 ◽

Vol 86 (5) ◽

pp. 734-739 ◽

Cited By ~ 10

Author(s):

Juliana S. Leite ◽

Luciano B. Matiussi ◽

Anne C. Salem ◽

Maria G. A. Provenzano ◽

Adilson L. Ramos

Keyword(s):

Early Treatment ◽

Primary Outcome ◽

Open Bite ◽

Mixed Dentition ◽

Secondary Outcome ◽

Cephalometric Analysis ◽

Anterior Open Bite ◽

Randomized Clinical Study ◽

Nasolabial Angle ◽

Cephalometric Measurements

ABSTRACT Objective: To evaluate the overbite correction of fixed palatal crib (FPC) and bonded lingual spur (BLS) in the early treatment of anterior open bite (AOB) in mixed dentition (primary outcome) as well as its influence on dental and skeletal cephalometric measurements (secondary outcome). Materials and Methods: The selected patients had AOB and a mean age of 8.23 years. They were divided into the following three groups by casting lots: control (n = 13), palatal crib (n = 13), and spur (n = 13). Data from the lateral teleradiography was obtained at the beginning, at 6 months, and after 1 year. The cephalometric analysis was performed by Cef-X program, recording the values of SNA, SNB, ANB, SnG oGn, 1.PP, IMPA, nasolabial angle, overbite, and overjet. Intergroup and intragroup comparisons were obtained via one-way analysis of variance. Results: The degree of AOB was similar at baseline (P > .05). At 6 months and then after 1 year all groups showed improvement in the overbite. However, only the crib and spur groups showed positive overbite. No cephalometric measurements changed significantly over the period analyzed. Conclusions: We conclude that the FPC and BLS are simple and effective for the treatment of anterior open bite, with the advantage given to the FPC.

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Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.22.5.030-038.oar ◽

2017 ◽

Vol 22 (5) ◽

pp. 30-38 ◽

Cited By ~ 6

Author(s):

Shuka Moshiri ◽

Eustáquio A. Araújo ◽

Julie F. McCray ◽

Guilherme Thiesen ◽

Ki Beom Kim

Keyword(s):

Open Bite ◽

Therapeutic Modality ◽

Occlusal Plane ◽

Anterior Open Bite ◽

Lower Incisor ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Treatment Changes ◽

Extraction Treatment ◽

Lower Molar

ABSTRACT Objective: The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA). Methods: Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm) were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP), SN to mandibular occlusal plane (SN-MnOP), mandibular plane to mandibular occlusal plane (MP-MnOP), SN to mandibular plane (SN-MP), SN to palatal plane (SN-PP), SN to gonion-gnathion plane (SN-GoGn), upper 1 tip to palatal plane (U1-PP), lower 1 tip to mandibular plane (L1-MP), mesiobuccal cusp of upper 6 to palatal plane (U6-PP), mesiobuccal cusp of lower 6 to mandibular plane (L6-MP), lower anterior facial height (LAFH), and overbite (OB). Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Results: Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. Conclusions: The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion.

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