scholarly journals Incidence and evaluation of open bite malocclusion and their management

Author(s):  
Md Anisur Rahman

Introduction: Open bite malocclusion is one of the most difficult dentofacial deformities to treat. Although this type of malocclusion can occur unilaterally or bilaterally in the buccal segments. It is mostly seen in the anterior segment where there is no incisal contact and vertical overlap of the lower incisors by the uppers. Objectives: The study was aimed to find out the incidence of open bite malocclusion and their pre and post treatment evaluation of the treated cases and also compare the result of two study groups (skeletal open bite and dental open bite). Methods: A total number of 31 patients with open bite malocclusion out of 1372 patients reported to Department of Orthodontics, Dhaka Dental College and Hospital for treatment. Out of them 21 patients were included in this study with mean age 22±5.4, who successfully completed treatment. Of them 14 were included in the dental group and 07 in the skeletal group. Pre treatment history, clinical examination along with pre and post-treatment photographs, study models and lateral cephalograms were used to compare the treatment outcome between the two study groups. Results: The incidence of open bite was 2.3%. Out of 21 open bite samples 14 were of dental type and the rest 07 were of skeletal type. 47.6% open bite had Angles Class I malocclusion, 42.9% were Class II and 9.5% were Class III. Cephalometric analysis of vertical measurements showed that the mandibular plane angle, palatal plane angle and SNA angle significantly decreased from pre-treatment to post-treatment (p<0.05) in both groups . Gonial angle remains unchanged. Cephalometric analysis of the linear and dental measurements showed increased upper face height, posterior facial height and inter-incisal angle. Soft tissue evaluation on cephalometry showed significant decrease of esthetic plane and interlabial gap. A statistically significant mean difference was found in case of negative overbites among the patients with dental group (p<0.001). Less time was required for completion of treatment in dental group and prognosis was significantly better (p<0.05) Conclusion: The result of the present study indicates that the treatment period and wear time of appliance in dental type was shorter than skeletal type. Both groups showed significant improvement though prognosis was better in dental type of open bite cases.DOI: http://dx.doi.org/10.3329/bjodfo.v2i2.16156 Ban J Orthod & Dentofac Orthop, April 2012; Vol-2, No.2, 1-7

2013 ◽  
Vol 7 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Teresa Sierpinska ◽  
Joanna Kuc ◽  
Maria Golebiewska

Advanced tooth wear often results in lost vertical dimension and impacts facial aesthetics. Complex restorative treatment can replace the lost tooth structure and improve functional occlusal and facial skeleton parameters. Purpose: The aim of the study is to assess changes in the morphological and functional occlusal parameters of the facial skeleton after prosthetic rehabilitation that increased lost occlusal vertical dimension. Material and Methodology: 50 patients with advanced tooth wear were clinically examined, to assess the degree of wear. Each subject underwent cephalometric analysis, digital occlusal analysis, and electromyographic analysis, of the anterior temporalis, superficial masetter, anterior digastric, and the sternocleidomastoid muscles. Prosthodontic treatment was performed to restore the occlusal vertical dimension of each subject’s occlusion, which was followed by repeating the pretreatment analyses. Pre and post treatment parameters were statistically compared. Results: Pre-treatment cephalometric analysis showed that lost vertical dimension reduced anterior facial height and resulted in small angular skeletal parameters. Post treatment anterior facial height increased from the increased occlusal vertical dimension. The mean value of functional electrical activity during clenching post treatment, increased compared to pretreatment. Conclusion: Increasing the vertical dimension of occlusion improved facial aesthetics by positively affecting facial skeletal angles. The restored occlusal surface morphology changed the pre treatment flat broad occlusal contacts into more point contacts. The increased vertical dimension of occlusion after treatment also increased muscle activity levels over the pretreatment levels after three months period of adaptation.


2013 ◽  
Vol 9 (1) ◽  
Author(s):  
Elena Krieger ◽  
Thomas Drechsler ◽  
Irene Schmidtmann ◽  
Collin Jacobs ◽  
Simeon Haag ◽  
...  

Abstract Introduction Objective of this study was to investigate the incidence and severity of apical root resorptions (ARR) during orthodontic treatment with aligners. Materials and methods The sample comprised 100 patients (17–75 years of age) with a class I occlusion and anterior crowding before treatment, treated exclusively with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). The following teeth were assessed: upper and lower anterior teeth and first molars. Root and crown lengths of a total of 1600 teeth were measured twice in pre- and post-treatment panoramic radiographs. Afterwards, relative changes of the root length during treatment were calculated by a root-crown-ratio taking pre- and post-treatment root and crown lengths into consideration. A reduction of this ratio was considered as a shortening of the initial root length. Additionally, tooth movements of the front teeth were assessed by lateral cephalograms and the 3-dimensonal set up of each patient. Results All patients had a reduction of the pre-treatment root length with a minimum of two teeth. On average 7.36 teeth per patient were affected. 54% of 1600 measured teeth showed no measurable root reduction. A reduction of >0%-10% of the pre-treatment root length was found in 27.75%, a distinct reduction of >10%-20% in 11.94%. 6.31% of all teeth were affected with a considerable reduction of >20%. We found no statistically significant correlation between relative root length changes and the individual tooth, gender, age or sagittal and vertical orthodontic tooth movement; except for extrusion of upper front teeth, which was considered as not clinical relevant due to the small amount of mean 4% ARR. Conclusions The present study is the first analyzing ARR in patients with a fully implemented orthodontic treatment with aligners (i.e. resolving anterior crowding). The variety was high and no clinical relevant influence factor could be detected. A minimum of two teeth with a root length reduction was found in every patient. On average, 7.36 teeth per patient were affected.


2021 ◽  
Vol 7 (2) ◽  
pp. 150-159
Author(s):  
Adeel Ahmed Bajjad ◽  
A K Chauhan ◽  
Anil Sharma ◽  
Santosh Kumar

The successful treatment of Orthodontic patient is dependent on careful diagnosis. Three planes of discrepancies are commonly described in orthodontics namely, transverse, sagittal and vertical. Of these, the sagittal discrepancies are most commonly encountered in day to day practice. This study was aimed to compare various methods of cephalometric analysis for assessing sagittal jaw relationship. There were total of 180 lateral cephalograms used and each samples were divided into 2 groups based on their skeletal relationship according to ANB angle. i.e Class I and Class II. Class I and Class II were again divided into average, horizontal and vertical group. Pretreatment records were taken and tracing were performed on the lateral cephalogram and measured values were recorded and subjected to statistical analysis.In class I, the highest frequency was seen in A-B plane angle and FABA angle and in class II the highest frequency found in K angle followed by A-B plane angle. In class I horizontal group, a strong level of agreement was found between AXB angle with AF-BF distance while in class II average group, A-B plane angle shows strong level of agreement with WITS and FABA angle. In terms of reliability, all the ten parameters (A-B plane angle, WITS, AF-BF distance, APP-BPP distance, FABA angle, BETA angle, YEN angle, W angle and K angle) show good reliability in class II average and vertical group. : No single measurement is perfect in all the cases. A combination of different measurements should be used to have a true assessment of sagittal jaw relationship.


2022 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Priyanka Satra ◽  
Gauri Vichare ◽  
Veera Bhosale

Objectives: The objectives of the study were to assess, measure, and correlate the maxillary and mandibular effective base length, arch length to the amount of dental crowding in different vertical growth pattern patients. Materials and Methods: Sample comprising 100 pre-treatment lateral cephalograms and study models (age group – 16–25 years) was randomly selected. The sample was divided into two groups, that is, clockwise (50) and anticlockwise (50) rotation based on the measurement of the gonial angle. The gonial angle and maxillary and mandibular effective lengths were measured on pre-treatment lateral cephalograms. Dental crowding and arch length were measured on the pre-treatment dental casts. Intergroup comparisons of effective base length, arch length, and crowding were performed with unpaired t-tests. Correlations between effective base length, arch length, and dental crowding were examined by means of Pearson’s correlation coefficient (P < 0.05). Results: Subjects with clockwise rotation significantly had more mandibular dental crowding and significantly decreased mandibular arch length compared to the anticlockwise group. An inverse correlation was found between maxillary and mandibular effective base length, arch length, and dental crowding while a positive correlation was found between maxillary and mandibular base length and arch length in both the groups. Conclusion: Clockwise rotation of the mandible along with skeletal and dental factors such as decreased effective base lengths and arch length, respectively, constitutes an important factor leading to dental crowding.


2007 ◽  
Vol 77 (6) ◽  
pp. 986-990 ◽  
Author(s):  
Nejat Erverdi ◽  
Serdar Usumez ◽  
Alev Solak ◽  
Tamer Koldas

Abstract Objective: To evaluate the dentoalveolar and skeletal effects of the new-generation open-bite appliance. Subjects and Methods: The study group was composed of 11 subjects with a mean age of 19.5 years who underwent intrusion of the posterior dentoalveolar segment using an open-bite appliance supported by bilateral zygomatic implants. The study was carried out on lateral cephalograms of the subjects taken before treatment and after intrusion. The mean intrusion time was 9.6 months. Results: The mean intrusion measured as the distance of the U6 to the palatal plane was 3.6 ± 1.4 mm (P &lt; .001). This resulted in an average of 3.0° ± 1.5° of closure of the Go-Gn-SN angle (P &lt; .001). The gain in the overbite was 5.1 ± 2.0 mm (P &lt; .001), and the overjet was reduced by 1.4 ± 1.5 mm (P &lt; .01). The change in the occlusal plane angle was an average of 2.4° ± 1.4° counterclockwise rotation (P &lt; .001). The lower facial height was also decreased significantly by 2.9 ± 1.3 mm (P &lt; .001). No significant changes were observed in the SNA angle and incisor positions (P &gt; .05), except for the interincisal angle, which was increased by 3.5° (P &lt; .05). Conclusion: Zygomatic anchorage can be used effectively for open-bite correction through posterior dentoalveolar intrusion.


2020 ◽  
Vol 54 (3) ◽  
pp. 226-232
Author(s):  
S. S. Agarwal ◽  
Sanjay Londhe ◽  
Rajat Mitra ◽  
Sanjeev Datana

Introduction: Maxillary advancement (MA) with rigid external distraction (RED) to correct mid-face deficiency in adult cases with cleft lip and palate (CLP) may trigger velopharyngeal incompetency (VPI) post-surgically. Aim and objectives: To determine pre-treatment factors affecting worsening of post-surgical VPI in patients with repaired unilateral CLP who underwent MA with RED. Material and methods: Treatment records of 10 patients with unilateral CLP who underwent MA with RED were selected from institutional archives. All patients underwent clinical evaluation of velopharyngeal function at T1 (1 week before surgery) and T2 (3 months after surgery). Based on post-surgical VPI status, patients were divided into 2 groups: group 1 (no change in VPI) and group 2 (worsened VPI). Lateral cephalograms were manually traced at T1 and T2 to determine the changes in length of soft palate (LSP) and pharyngeal depth (PD) at T2. The information regarding amount of MA and presence of pre-surgical VPI was obtained from case sheets of patients. Results: Mean LSP and PD at T2 were higher compared to T1 ( p-value < .001). No significant difference was observed in mean pre-surgical age, gender, pre-surgical LSP, and pre-surgical PD between the study groups ( p-value > .05 for all). The worsened VPI post-surgically was significantly associated with the presence of VPI pre-surgically and also with the amount of MA ( p-value < .05 for both). Conclusions: Amount of MA and presence of pre-surgical VPI are most important factors affecting post-surgical VPI. Prospective studies are recommended to validate the findings of this study.


2019 ◽  
Vol 24 (3) ◽  
pp. 46-54
Author(s):  
Paola Janett Caballero-Purizaga ◽  
Luis Ernesto Arriola-Guillén ◽  
Gustavo Adolfo Watanabe-Kanno

ABSTRACT Objective: The objective of this research was to demonstrate the efficiency of the overbite depth indicator (ODI) and the anteroposterior dysplasia indicator (APDI) from Kim’s cephalometric analysis, regarding the determination of the vertical and sagittal patterns of Latin American individuals. Methods: Two hundred lateral cephalometric radiographs were selected and divided into four study groups, with 50 radiographs each, for carrying out a cross-sectional study. The control group included radiographs of balanced individuals, and the other three groups had lateral cephalometric radiographs of subjects with Class I, II and III malocclusions and with skeletal open bite. After the pilot test was performed to calibrate the investigator, the ODI and APDI were measured. Descriptive statistics were performed and the one-way ANOVA with post-hoc Tukey HSD, or Kruskal-Wallis and Mann-Whitney U-test were used. Also a multiple linear regression was employed. Results: Statistically significant differences were found for the ODI of all groups (p< 0.001), except between Class I group (65.87 ± 4.26) and Class II open bite group (67.19 ± 3.58), both with similar values to each other. For APDI, statistically significant differences were also found for all groups (p< 0.001). However, no statistically significant differences were found between the balanced group (83.18 ± 1.71) and Class I group with skeletal open bite (81.78 ± 2.69). Conclusions: ODI and APDI are reliable indicators to evaluate the sagittal and vertical patterns of an individual, demonstrating their efficiency when a Latin American population was evaluated.


Author(s):  
Anja Quast ◽  
Petra Santander ◽  
Johanna Leding ◽  
Daniela Klenke ◽  
Norman Moser ◽  
...  

Abstract Objectives Sufficient dental decompensation is crucial for treatment success in combined orthodontic-surgical treatment. The study’s objective was to determine the treatment success and efficiency in sagittal, vertical, and transversal decompensation. Methods This longitudinal, observational study enrolled 52 adult patients, who underwent orthodontic-surgical treatment. Incisor inclinations and positions as well as skeletal changes were assessed pre-treatment (T1), pre-surgical (T2), and post-surgical (T3) by lateral cephalograms and CBCT scans. Results Incisor decompensation was insufficient in all three dimensions. Sagittal: treatment efficiency did not differ between class II and III patients. Vertical: patients with open bite demonstrated pre-surgical bite deepening and insufficient surgical reduction of the maxillomandibular plane angle. Transversal: Dental midline deviations were not adapted to the skeletal asymmetry so that menton deviations were not properly corrected. Conclusions Incisor decompensation was not as successful as requested in all three dimensions and the treatment ideal was seldom achieved. Clinical relevance To improve the skeletal outcome, the orthodontist has to treat the patient with the desired surgical movements in mind and should critically evaluate the pre-surgical incisor decompensation before referral to the surgical team.


2017 ◽  
Vol 07 (02) ◽  
pp. 008-018
Author(s):  
Kaushik Shetty ◽  
Saidath K. ◽  
Akhil Shetty ◽  
M. S. Ravi ◽  
Keerthan Shashidhar ◽  
...  

Abstract Aims: To assess the changes in the oropharyngeal airway (OAW) dimensions in individuals with retrognathic mandible treated with Forsus FRD and Twin Block appliance to correct the skeletal Class II mal relationship. Methodology: 40 individuals, with Class II skeletal pattern were selected as per inclusion criteria. Pre-treatment lateral cephalograms and hand wrist radiographs were obtained and analyzed. Group 1 with 20 individuals were treated with Forsus FRD and Group 2 with 20 individuals were treated with conventional Twin Block Appliance. Post treatment records were taken after the Class I molar relationship had been obtained. Pre and post treatment cephalograms were compared and analyzed. The data obtained was statistically evaluated using paired t test and unpaired t test. Results: On comparison of pre-treatment and post-treatment cephalograms, increase in Oropharyngeal Airway (OAW) measurements, such as Superior posterior airway space (SPAS), Middle airway space (MAS) and Inferior airway space (IAS) was very highly significant. Conclusion: Our results suggest the existence of a relationship between functional-orthopaedic treatment and increases in OAW dimensions in skeletal Class II growing subjects.


Author(s):  
Mahamad Irfanulla Khan ◽  
Praveen Kumar Neela ◽  
Nayeem Unnisa ◽  
Ajit Kumar Jaiswal ◽  
Nadeem Ahmed ◽  
...  

Background and aim. Class II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible. Methods. Pre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age  =  10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test. Results. The cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p<0.001) increase in mandibular length (6.02 mm) compared with the control group (0.3 mm). ‘Headgear effect’ on the maxilla, increase in lower anterior facial height, significant reduction of overjet, overbite and Class I molar relationship was achieved in the Twin Block group. However, no significant changes appeared in the control group. Conclusion: The results of the present study conclude that the Twin Block appliance is effective in the treatment of Class II malocclusion and this is due to a combination of skeletal and dentoalveolar changes in both the arches.


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