scholarly journals Inconsistencies in the Differential Diagnosis of Open Bite

2008 ◽  
Vol 78 (3) ◽  
pp. 415-420 ◽  
Author(s):  
Zuleyha Mirzen Arat ◽  
Mehmet Okan Akcam ◽  
Elçin Esenlik ◽  
F. Emel Arat

Abstract Objective: To examine inconsistencies in the differential diagnosis of open bite. Materials and Methods: Using visual judgments, a total of 77 anterior open-bite cases in the postpubertal growth period were grouped as either morphogenetic, functional, or combination. The same sample was also grouped as either hyperdivergent, normodivergent, or hypodivergent using mandibular-plane angle and conventional cephalometry. Kappa analysis was used to test the agreement between the 2 methods of evaluation, and χ2 tests were used to analyze the distribution of cephalometrically grouped hyperdivergent, normodivergent, and hypodivergent cases among the visually assessed morphogenetic, functional and combination groups and vice versa. A κ score of 0.343 indicated a weak agreement between visual judgment and cephalometric methods of evaluation (P < .001). Results: Despite the expectation that cases evaluated as hyperdivergent using cephalometry would be visually evaluated as morphogenetic, more than half of the cases assessed as hyperdivergent were in fact classified as functional. Conclusions: These findings highlight the inadequacy of relying solely on cephalometric evaluation to classify open bite.


2021 ◽  
Author(s):  
Ahmed I. Masoud ◽  
T. Peter Tsay

ABSTRACT Amelogenesis imperfecta is a rare hereditary disorder that affects dental enamel and is often associated with an anterior open bite. Orthodontic treatment of a 16-year-old female patient with hypocalcified amelogenesis imperfecta and a 9-mm anterior open bite was presented. Radiographic examination revealed a steep mandibular plane angle, an increased lower face height, a Class II skeletal pattern, and a convex profile. Additionally, the patient had stainless steel crowns on all upper and lower posterior teeth and composite veneers on the upper anterior teeth. The patient was treated nonsurgically using a multiloop edgewise archwire (MEAW). MEAW mechanics allowed for successful correction of the anterior open bite, with significant reduction in the mandibular plane angle and improvement in the patient's profile. No fixed retainers were used, results remained stable 78 months after removal of orthodontic appliances. MEAW mechanics should be considered for patients with large anterior open bites, although this technique requires excellent patient compliance.





2018 ◽  
Vol 89 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Bella Shen Garnett ◽  
Kimberly Mahood ◽  
Mai Nguyen ◽  
Aliaa Al-Khateeb ◽  
Siqi Liu ◽  
...  

ABSTRACT Objectives: To compare fixed appliances and clear aligner therapy in correcting anterior open bite and in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns. Materials and Methods: In this retrospective study, two treatment groups of adult (≥18 years old) hyperdivergent patients (mandibular plane angles of ≥38°) with anterior open bites were included: 17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurements representing the vertical dimension were reported for each group. A two-sample t-test was used to assess differences in changes in mandibular plane angle and overbite between the two treatment groups. Results: There were no statistical differences found in the magnitude of overbite correction and the changes in any of the cephalometric measurements for vertical control. The clear aligner group showed a slightly greater amount of lower incisor extrusion (P = .009). The main mechanism of open bite correction was similar between the two treatment groups and was accomplished through retroclination of the upper and lower incisors while maintaining the vertical position of the upper and lower molars. Conclusions: Cephalometric comparison of anterior open bite correction and changes in the mandibular plane angle associated with use of clear aligners and fixed appliances did not demonstrate statistically significant differences in adult hyperdivergent patients.



2014 ◽  
Vol 19 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Helder Baldi Jacob ◽  
Ary dos Santos-Pinto ◽  
Peter H. Buschang

INTRODUCTION: Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry - State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance. METHODS: The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go). RESULTS: Treatment caused significantly greater angle decrease between the palatal and the mandibular plane of the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group. CONCLUSIONS: The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height.



2021 ◽  
pp. 146531252110000
Author(s):  
Peter Fowler ◽  
Jennifer Haworth ◽  
Leon Steenberg

Background: The correction of severe anterior open bite is technically challenging, often requiring the use of complex orthodontic mechanics and/or orthognathic surgery and has a relatively high risk of relapse. A marked reverse curve of Spee in the lower arch presents additional challenges when correcting a severe anterior open bite. Methods and Materials: A 22.2-year-old Caucasian man presented with concerns relating to poor anterior occlusion associated with a 1.3-cm anterior open bite. There was an accentuated reverse curve of Spee to the lower arch, an increased maxillary-mandibular plane angle and increased lower face height. Multidisciplinary treatment involving the use of segmental anterior mandibular distraction to level the curve of Spee before undertaking a Le Fort I posterior maxillary impaction is described in this case report. Results: Long-term post-treatment records showed stable anterior open bite correction. Conclusions: This case report illustrates the successful use of segmental anterior mandibular vertical distraction followed by conventional Le Fort I posterior impaction surgery to correct a severe anterior open bite associated with an accentuated reverse curve of Spee and high maxillary-mandibular plane angle.



2012 ◽  
Vol 83 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Sawako Uehara ◽  
Aya Maeda ◽  
Hiroshi Tomonari ◽  
Shouichi Miyawaki

Abstract Objective: To determine the root-crown (R/C) ratio and dental root length of teeth in patients with open bite and seek any relationships with occlusal contact (OC) and the mandibular plane (Mp) angle. Materials and Methods: Thirty-one patients with open bite with negative overbite of at least four anterior teeth and 31 control patients with clinically normal overjet and overbite were enrolled. R/C ratios, dental root length, OC, and Mp angle were measured using panoramic radiographs, dental casts, and cephalograms, respectively. Mean differences between the groups, and variations between the R/C ratio or root length and Mp angle in patients with open bite were statistically analyzed. Results: R/C and OC ratios from the incisors to premolars were significantly lower for patients with open bite than for controls, and some teeth had short dental roots. Relationships between low R/C ratio or root length and high Mp angle were significant in patients with open bite. Conclusion: Patients with open bite, especially those with a high Mp angle, have an unfavorable R/C ratio and short dental roots in some teeth, which may be related to the loss of OC.



2018 ◽  
Vol 23 (6) ◽  
pp. 48-55 ◽  
Author(s):  
Waqar Jeelani ◽  
Mubassar Fida ◽  
Attiya Shaikh

ABSTRACT Introduction: Maxillary incisal display is one of the most important attributes of smile esthetics. Objective: The aim of this study was to determine the relationship between maxillary incisal display at rest (MIDR) and various soft tissue, hard tissue and dental components. Methods: A cross-sectional study was conducted on 150 subjects (75 males, 75 females) aged 18-30 years. The MIDR was recorded from the pretreatment orthodontic records. The following parameters were assessed on lateral cephalograms: ANB angle, mandibular plane angle, palatal plane angle, lower anterior and total anterior facial heights, upper incisor inclination, upper anterior dentoalveolar height, and upper lip length, thickness and protrusion. The relationship between MIDR and various skeletal, dental and soft tissue components was assessed using linear regression analyses. Results: The mean MIDR was significantly greater in females than males (p = 0.011). A significant positive correlation was found between MIDR and ANB angle, mandibular plane angle and lower anterior facial height. A significant negative correlation was found between MIDR and upper lip length and thickness. Linear regression analysis showed that upper lip length was the strongest predictor of MIDR, explaining 29.7% of variance in MIDR. A multiple linear regression model based on mandibular plane angle, lower anterior facial height, upper lip length and upper lip thickness explained about 63.4% of variance in MIDR. Conclusions: Incisal display at rest was generally greater in females than males. Multiple factors play a role in determining MIDR, nevertheless upper lip length was found to be the strongest predictor of variations in MIDR.



2004 ◽  
Vol 41 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Noriyuki Kitai ◽  
Yoshitaka Iguchi ◽  
Mariko Takashima ◽  
Shumei Murakami ◽  
Sven Kreiborg ◽  
...  

Objective To examine the three-dimensional morphology of internal structures of the craniofacial region and present the orthodontic problems in an unusual case with nasal aplasia. Patient The patient was an 11.5-year-old boy with aplasia of the nose and nasal cavity with extremely constricted nasopharyngeal airway. He did not have mental or somatic retardation. The patient had dacryostenosis. The morphology of the craniofacial structures was characterized by absence of septal structures, including cribriform plate, perpendicular plate of ethmoid bone, vomer, and septal cartilage; bony hypotelorism; midface hypoplasia; short and retrognathic maxilla with Class III jaw relationship; average mandibular plane angle; high arched palate; severe anterior open bite with bilateral posterior crossbites; and dental anomalies (agenesis of four maxillary permanent teeth, microdontia, taurodontism, and short roots). Thus, the patient had characteristic dentofacial phenotype, which might be caused by a combination of the primary anomaly and the functional disturbances secondary to the nasal obstruction.



2017 ◽  
Vol 22 (5) ◽  
pp. 30-38 ◽  
Author(s):  
Shuka Moshiri ◽  
Eustáquio A. Araújo ◽  
Julie F. McCray ◽  
Guilherme Thiesen ◽  
Ki Beom Kim

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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