Abstract
ABSTRACTObjective: 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.
Highlights
Open bites pose as one of the more challenging dentofacial deformities in the orthodontic world, as they tend to defy treatment.[1,2,3] many researchers contend that vertical discrepancies are more difficult to manage than those in the anteroposterior dimension.[4,5] The complexity of this particular bite stems from both the mechanics needed to treat it and the efforts to combat its high relapse tendency
Significant (p < 0.01) changes were found in 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 gonion-gnathion plane (SN-GoGn), lower anterior facial height (LAFH), overbite, and lower 1 tip to mandibular plane (L1-MP)
A plethora of evidence lends credence to the idea that skeletal open bite patients tend towards high mandibular plane angles[1,17,18] and large lower anterior facial heights (LAFH).[7,12,17,18,19]
Summary
Open bites pose as one of the more challenging dentofacial deformities in the orthodontic world, as they tend to defy treatment.[1,2,3] many researchers contend that vertical discrepancies are more difficult to manage than those in the anteroposterior dimension.[4,5] The complexity of this particular bite stems from both the mechanics needed to treat it and the efforts to combat its high relapse tendency. Due to lack of anterior contact, anterior open bites can lead to excessive wear of the posterior dentition, as the patient lacks anterior disclusion. The etiology of anterior open bites is complex and multifaceted. It may develop from either oral habits, excessive growth of lymphatic tissues, tongue position, or a genetic predisposition. While growing patients may be treated with interceptive orthodontic appliances, treatment of adult patients presents a more complex picture once growth has ceased and habit-related sequela assume permanence.[7,8]
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