Correction Of Anterior Open Bite Research Articles

Anterior open bite correction via molar intrusion: Diagnosis, advantages, and complications

Anterior open bite can be effectively treated nonsurgically via molar intrusion. This technique, involving the intrusion of posterior teeth using temporary skeletal anchorage devices, prompts counterclockwise rotation of the mandible. This rotation not only corrects anterior open bite but also contributes to a decrease in anterior facial height, improvements in lip incompetency, and forward movement of the chin. For successful outcomes, temporary skeletal anchorage devices, installed on both the buccal and palatal sides, must deliver equivalent intrusion force to the maxillary teeth. Treatment planning should consider factors such as skeletal discrepancies, vertical excess, incisor exposure, and configuration of the occlusal plane. Clinicians are advised to closely monitor periodontal changes and consider overcorrection to ensure lasting stability and maintenance of incisal overlap post-treatment.

Orthodontic correction of acquired open bite with TMJ degeneration: A retrospective study of outcomes and stability

Newly developed temporary anchorage devices (TADs) serve a strong orthodontic anchorage to intrude molars for correction of anterior open bite (AOB). We measured cephalometric changes in skeletal open bite patients which developed subsequently to temporomandibular joint disorders with bilateral point contacts at terminal molars. We retrospectively recruited 32 patients who had been treated their TMD before orthodontic correction (overbite: -3.14±1.86mm). Partial orthodontic appliances were used to intrude posterior teeth using TADs until positive OB obtained (T1). Full fixed appliances were then used to achieve proper overjet and overbite (T2). We collected lateral cephalograms before (T0), during (T1) and after (T2) treatment, and at follow-ups (T3). Using ANOVA, we analyzed the differences among these time points to determine treatment changes and stability of orthodontic results. In this group predominantly comprising young adult women, orthodontic treatment with TADs significantly reduced upper posterior dental heights (T2-T0:-1.84±0.66mm) and facilitated the retraction and uprighting upper incisors (T2-T0: -9.92±1.72°), to achieve appropriate OJ (T2-T0: -3.21±0.49mm) and OB (T2-T0: 4.10±0.28mm) with p<0.05. Except upper posterior dental height, most of cephalometric changes including OJ, OB, and upper incisal axis remained significant at follow-ups with retention time of 3.7±2.6 years. Only three out of 30 patients experienced small amount of open bite at T3. Orthodontic correction of OJ remained relatively stable among 90% of patients with TMJ degeneration by intrusion via TADs. This modern but conservative orthodontic approach can improve occlusal functions in skeletal open bites.

A Novel Approach for Anterior Open bite Correction

A Novel Approach for Anterior Open bite Correction

Predictability of anterior open bite treatment with Invisalign

Anterior open bite correction with Invisalign has been claimed to have relatively good predictability because of the proposed function of clear aligners to function as occlusal bite-blocks, limiting extrusion of the posterior teeth or possibly even intruding posterior teeth. This proposal, however, remains relatively unsubstantiated. The objective of this study was to investigate and determine the accuracy of Invisalign treatment in correcting anterior open bite by comparing the predicted outcome from ClinCheck to the achieved outcome for the initial aligner sequence. A retrospective study used pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 76 adult patients from private specialist orthodontic practices. Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners. Geomagic Control X software was used to measure overbite and overjet in the pretreatment, posttreatment, and predicted outcomes stereolithography files for each patient. Approximately 66.2% of the programmed open bite closure was expressed compared with the prescribed ClinCheck outcome. The use of posterior occlusal bite-blocks and prescribed movement of teeth via anterior extrusion, posterior intrusion, or a combination of the 2 made no difference to the efficacy of open bite closure. Two-week aligner changes resulted in 0.49 mm more bite closure on average. The prescribed bite closure in ClinCheck software overestimates the bite closure that is clinically achieved.

The efficacy of anterior open bite closure when using Invisalign's optimized extrusion versus conventional attachments.

Clear aligners are reported to control anterior open bites. Despite this, anterior extrusion remains difficult with aligners. Optimized extrusion attachments on incisors may facilitate anterior extrusion to correct open bite with Invisalign. The aim of this retrospective study was to compare the efficacy of anterior open bite correction with Invisalign when using optimized extrusion versus conventional attachments. This was a retrospective cohort study. The pre- and post-treatment intraoral scans of patients with anterior open bite treated with Invisalign aligners were assessed. Patients were divided into two groups: group A, patients with horizontal conventional attachments and group B, patients with optimized extrusion attachments on incisors. The pre and post-treatment overbite and the planned overbite change were measured and compared between the groups. Descriptive statistics were computed and statistical significance was set at P < 0.05. A total of 86 patients were included. Both groups showed significant increases in overbite, but there was no difference in the open bite correction efficacy in patients with conventional versus optimized attachments. Shorter treatment times for open bite closure were reported for patients with optimized attachments. Anterior open bite can be corrected regardless of the attachment type. Optimized attachments are no more effective than using conventional attachments in incisor extrusion to correct open bite. Patients with anterior open bite with optimized attachments observed shorter treatment times for overbite correction. When correcting anterior open bite with Invisalign, the attachment type does not improve the success rate. Optimized extrusion attachments on incisors may shorten the treatment time compared to conventional attachments.

Correction of anterior open bite malocclusion with a temporary skeletal anchorage device–supported appliance

To evaluate the dental and skeletal changes using a novel miniscrew-supported bite-closing appliance (MBCA) to correct anterior open bite. A novel MBCA that uses nickel-titanium springs connected to miniscrews combined with a biteplate and a low-hanging transpalatal arch to intrude posterior teeth was used. Using cone-beam computed tomography (CBCT) and cephalograms, skeletal and dental changes were measured and discussed in 25 patients with open bites consecutively treated with this appliance. The MBCA significantly decreased the open bite (2.9 ± 0.1 mm; P <0.0001). Relative to FH, intrusion was achieved on the maxillary second premolars (−2.0 ± 1.5 mm; P <0.0001), first (−2.3 ± 1.8 mm; P <0.0001), and second molars (−1.9 ± 1.6 mm; P <0.0001). This was supported by the results from the CBCT superimpositions that showed intrusion of the maxillary second premolar (−3.2 ± 1.6 mm) and the maxillary first and the second molars (−2.8 ± 1.5 mm and −2.1 ± 1.6 mm, respectively). This resulted in favorable skeletal changes exhibited by a significant decrease in FMA (−1.4 ± 2.2°; P <0.005), SN-MP (−1.8 ± 2.4°; P <0.005), and an increase in PFH (1.2 ± 1.4 mm; P <0.05) and SN-NPog (1.4 ± 2.2°; P <0.05). These results are consistent with the counterclockwise rotation of the mandible. A mandibular lingual holding arch resulted in better vertical control of the mandibular posterior teeth (P <0.05). Follow-up on patients with available posttreatment CBCTs (n = 8) suggests some dental relapse at the second premolar (1.5 ± 3.0 mm) and the first (1.7 ± 2.4 mm) and second molars (1.7 ± 2.4 mm), but the skeletal changes were maintained. Visual assessment of patients with posttreatment photographs (n = 18) showed that positive overbite was maintained in all subjects. MBCA can provide satisfactory correction of the anterior open bite through counterclockwise rotation of the mandible.

Dentoalveolar effects of skeletally anchored extrusion arch in anterior open bite patients: A prospective clinical trial.

The purpose of this prospective clinical trial was to explore the dental and soft tissue changes accompanying the use of skeletally anchored nickel-titanium (NiTi) extrusion arch in the correction of anterior open bite (AOB). Twenty female patients with a mean age of 16.5 ± 1.5 years and a mean dentoalveolar AOB of 2.38±0.7 mm participated in this study. All patients were treated with an maxillary 0.017×0.025-in NiTi extrusion arch, with the aid of miniscrews inserted between the maxillary second premolars and first molars bilaterally, to act as indirect anchorage. Three-dimensional digital models and lateral cephalometric radiographs were taken just before the insertion of the extrusion arch (T0) and after 10 months (T1). Paired-sample t-tests were used in analyzing the data, to evaluate the changes after treatment (T1-T0). A significance level of p < 0.05 was used. AOB was successfully closed in all patients, with a 4.35 ± 0.61 mm increase in the overbite. Maxillary incisors significantly extruded (2.52 ± 1.02 mm) and significantly reclined (5.78 ± 0.77°), with a resultant decrease in the overjet of 1.58 ± 0.5mm. A significant intrusion of maxillary first molars with no change in their inclination was observed. The upper lip showed a significant retraction tendency to the E-plane, and a significant increase in the nasolabial angle was observed. The skeletally anchored NiTi extrusion arch was an effective technique in treating AOB, with no adverse effects on the molars.

Abordagem interdisciplinar no tratamento da macroglossia na síndrome de Beckwith-Wiedemann: relato de caso

ABSTRACT This study aims to report the interdisciplinary management of macroglossia in a Beckwith-Wiedemann syndrome patient during ten years. Clinical follow-up started by the Oral and Maxillofacial Surgery team, followed by Speech Therapy due to feeding difficulties. After clinical and instrumental evaluation, at 8 months old, the speech therapy intervention was indicated, focusing on oropharyngeal dysphagia and orofacial myofunctional therapy. At 1 year and 11 months, no signs of swallowing alteration in the pharyngeal phase and improvement in the posture of the lips and tongue were found. At the age of 3, stimulation to remove oral habits and train masticatory function were initiated. Orthodontic treatment to correct anterior open bite and unilateral posterior crossbite started at age 6. At 7 years and 5 months, there was stability in the nasal breathing mode and adequacy of resting posture of lips and tongue. At the age of 9, due to relapse of the occlusal alterations, surgical reduction of the tongue was indicated, followed by orofacial myofunctional therapy, restarted at the age of 9 years and 3 months. The result was the correction of the posture of the tongue during swallowing and speech adequacy. The association of treatments involving Speech Therapy, Orthodontics and Oral and Maxillofacial Surgery was considered effective in the management of the macroglossia. It resulted in the adequacy and equilibrium of orofacial functions.

Camouflage Treatment of Skeletal Anterior Open Bite with Tongue Training

The aim of this case report was to present an adult patient who suffered from poor occlusal function and poor aesthetic appearance due to skeletal anterior open bite. After orthodontic treatment, she was satisfied with improvements of mastication and esthetics. A case of 20-year-old female with skeletal Class II jaw relationship, mandible retrognathism and anterior open bite without signs and symptoms of temporomandibular disorder. Intraoral examination showed premature contact over bilateral posterior teeth and the forward resting position of tongue. Our treatment plan was orthodontic camouflage with extraction of all first premolars and tongue training. As forward resting position of tongue was noted, a tongue crib soldered on molar bands was used and the patient was instructed with tongue exercises. Normal overbite and overjet were achieved within four years of treatment. Her profile became more harmony after correction of anterior open bite. Although the stability of occlusion relies on the position of tongue, the current masticatory and facial profile provide a better quality of life. Orthodontic treatment of skeletal anterior open bite should be very careful. Appropriate diagnosis, differentiation of etiology and proper selection of mechanics must be verified before initiating treatment.

Effect of maxillary molar intrusion on surrounding bone density during treatment of anterior open bite

The aim of the current work is to estimate the impact of posterior maxillary intrusion on the surrounding bone intensity during correction of anterior open bite (AOB). The sample was 14 patients suffering from mild to moderate (3-5mm) anterior open bite with increased posterior maxillary vertical height. This study sample was allocated into two groups according to the corticotomy the approach. Buccal miniplates and palatal mini screws were used as skeletal anchorage for maxillary molars’ intrusion. The density of the alveolar bone related to right and left maxillary first permanent molars were measured 4.5 months after intrusion commencement. The study revealed that the alveolar bone density of right and left first permanent molars had statistically significant decreases. In the right side, buccal and palatal cortical density had statistically significant decrease, however it was non significant for left both cortical bone. Absolute molar intrusion could be attained by skeletal anchorage miniplates and mini screws in patients with frontal open bite malocclusion. The variation of bone intensity between buccal and palatal sides may account for the variance bone thickness changes after intrusion from the buccal to the palatal sides.

Posttreatment stability of an anterior open-bite by molar intrusion compared with 2-jaw surgery - a retrospective study.

This study aimed to compare post-treatment stability in patients with anterior open-bite (AOB) between those treated surgically (orthognathic 2-jaw surgery) and non-surgically (molar intrusion using orthodontic miniscrews). All subjects had initial overbite (OB) < -1mm and lateral cephalograms taken before treatment (T0), immediately after AOB correction (T1), after orthodontic treatment (T2), and at least 1year after treatment (T3). The non-surgical group was enrolled retrospectively; then, the surgical group was matched by OB, sex, and age to the non-surgical group (n = 21 each). Changes in cephalometric measurements during treatment (T1-T0), finishing (T2-T1), and retention (T3-T2) periods were compared between two groups. OB increased by 4.5-5.1mm during the treatment period with 3.3mm upward movement of the maxillary first molar (U6) in both groups. Changes in OB were not significantly different between the groups: 0.5-0.9mm increase during the finishing period but 1.0mm decrease during the retention period (P > 0.05). U6 moved 0.5mm downward in non-surgical group and 0.1mm upward in the surgical group during the finishing period, and 1.0mm and 0.4mm downward in the non-surgical and surgical groups, respectively, during the retention period. Post-treatment stability of AOB was similar for surgical and non-surgical methods (76.8 - 78.7%), although U6 moved more downward in the non-surgical group than in the surgical group. AOB without severe skeletal deformity can be treated by either molar intrusion or orthognathic surgery with similar treatment outcome and stability.

Orofacial Myofunctional Therapy Effectivity in Child's Anterior Open Bite

Background: Anterior Open Bite (AOB) is a malocclusion condition characterized by the absence of contact between the upper and lower anterior teeth, resulting from oral bad habits for a long time or abnormalities in skeletal patterns. AOB leads a lack of confidence in children because of the difficulty for lip sealing and the unclear pronunciation function. AOB occurs in children and continues into adulthood so it needs to be treated early on at the age of growth and development. One method of treating AOB is Orofacial Myofunctional Therapy (OMT) which is a method to improve the stability of the stomatognatic system by involving the exercise of the facial and neck muscles. Aim: Literature Review (LR) writing aims to find out the effectiveness of OMT in the case of AOB children, how the treatment is carried out and the problems that occur during OMT. Mini-Review: OMT increases the activity of the masseter and buccinator muscles, and decreases the contraction of the lip muscles that the lips may seal. OMT is able to increase the ability to hold the tongue to stay in contact with the palate so there is no obstacle to the eruption of the lower insisivus tooth and AOB can be corrected. Results: Orofacial Myofunctional Therapy (OMT) is effective for the correction of a child's Anterior Open Bite (AOB) as a combination therapy with the use of orthodontic tools or myofunctional equipment, especially in children older than 12 years of age and craniofacial deformity has occurred.

Orofacial Myofunctional Therapy Effectivity in Child's Anterior Open Bite

Background: Anterior Open Bite (AOB) is a malocclusion condition characterized by the absence of contact between the upper and lower anterior teeth, resulting from oral bad habits for a long time or abnormalities in skeletal patterns. AOB leads a lack of confidence in children because of the difficulty for lip sealing and the unclear pronunciation function. AOB occurs in children and continues into adulthood so it needs to be treated early on at the age of growth and development. One method of treating AOB is Orofacial Myofunctional Therapy (OMT) which is a method to improve the stability of the stomatognatic system by involving the exercise of the facial and neck muscles. Aim: Literature Review (LR) writing aims to find out the effectiveness of OMT in the case of AOB children, how the treatment is carried out and the problems that occur during OMT. Mini-Review: OMT increases the activity of the masseter and buccinator muscles, and decreases the contraction of the lip muscles that the lips may seal. OMT is able to increase the ability to hold the tongue to stay in contact with the palate so there is no obstacle to the eruption of the lower insisivus tooth and AOB can be corrected. Results: Orofacial Myofunctional Therapy (OMT) is effective for the correction of a child's Anterior Open Bite (AOB) as a combination therapy with the use of orthodontic tools or myofunctional equipment, especially in children older than 12 years of age and craniofacial deformity has occurred.

Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients.

ObjectiveThe purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases.MethodsSixty-nine adult patients with anterior open bite were enrolled and classified into Angle’s Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated.ResultsPositive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes.ConclusionsClear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.

Three-dimensional evaluation of anterior open bite correction in adult orthodontic patients: A prospective clinical study

Three-dimensional evaluation of anterior open bite correction in adult orthodontic patients: A prospective clinical study

Surgical-orthodontic Treatment of Skeletal Class III Malocclusion and Concomitant Open Bite: A Case Report

Surgical-orthodontic treatment for the correction of skeletal Class III malocclusion and concomitant open bite is challenging due to the probability of postsurgical relapse. The present case describes successful surgical-orthodontic treatment for the correction of Class III malocclusion with anterior and posterior open bite. Treatment consisted of the use of an Edgewise fixed appliance (0.022” × 0.028”) and bimaxillary orthognathic surgery. Treatment resulted in bilateral Class I molar and canine relationships, normal overjet and overbite, the correction of anterior and posterior open bite, alignment of the midlines, leveling of the curve of Spee, satisfactory facial harmony, and passive lip seal. The correct diagnosis as well as the proper indication and execution of orthodontic and surgical treatments enabled the achievement of satisfactory functional and facial results and smile esthetics.

Outcomes and Stability of Anterior Open Bite Treatment with Skeletal Anchorage in Non-Growing Patients and Adults Compared to the Results of Orthognathic Surgery Procedures: A Systematic Review.

The objective of this review is to evaluate, on the basis of the available literature, if anterior open bite (AOB) can be successfully treated with the intrusion of molar teeth using skeletal anchorage in non-growing patients and adults and if this treatment modality provides comparable results to those obtained by orthognathic surgery procedures. Methods: A systematic review of published data in major databases from 2000 to 2021 was performed. Results: In total, 92 articles were included in title and abstract screening, and only 16 articles (11 concerning AOB correction by molar intrusion with skeletal anchorage, and five considering AOB treatment by orthognathic surgical intervention) qualified for thorough data extraction and analysis. Conclusions: On the basis of this review, it seems to be possible to obtain successful results for AOB treatment in non-growing patients and adults by means of the intrusion of molar teeth with skeletal anchorage. However, due to the different methods of assessing treatment outcomes used by different authors, it is not possible to state conclusively whether the treatment of AOB by means of molar intrusion with skeletal anchorage provides long-term results that are comparable to orthognathic surgery procedures.

Openbite in hyperdivergent adult: Le Fort I impaction versus maxillary molar intrusion using bone anchorage. A literature review.

The objective of this study is to compare, based on literature review, the short and long-term efficiency of the correction of anterior openbite in hyperdivergent adults by orthodontics combined with maxillary molar intrusion using temporary anchorage devices (group A), versus maxillary surgical impaction (group B). The articles were retreived from five databases (last update in May 2020). Data selection and extraction are done independently by two reviewers, then validated and gathered after consensus to limit bias. Twelve low to medium evidence level studies meet the inclusion criteria, including two dedicated to jaw impaction surgery. All the studies analyzed short-term dentoskeletal changes, six assessed long-term stability up to 3.5 years for group B and to 4 years for group A. Both groups showed a decrease in anterior facial height and closure of the anterior openbite by mandibular autorotation. The results were stable over the long term for both groups. The orthodontic solution of molar intrusion associated with skeletal anchorage is an alternative to the surgical solution of mild skeletal openbite in adults. Randomized controlled clinical trials with control groups are essential to reach reliable conclusions.

Personalized Mechanotherapy: Simultaneous Correction of Posterior Crossbite and Anterior Open Bite in the Presence of Root Shortening

Personalized Mechanotherapy: Simultaneous Correction of Posterior Crossbite and Anterior Open Bite in the Presence of Root Shortening

Application of magnets in orthodontics –A review

Magnets have been widely used in orthodontics, there have been concerns regarding their safety and possible harmful effects. Magnets are used in number of conditions like, Relocation of Unerupted teeth; Space closure with magnets; Molar intrusion and correction of anterior open bite; Molar distalization; Maxillary expansion; Functional appliances for correction of Class II malocclusion; Functional Appliances for Class III malocclusions; Treatment of obstructive sleep apnea, snoring; Extrusion of crown-root fractured teeth; Closure of mid-line diastema; Correction of hemifacial microsomia. At present the most promising clinical uses for these magnets are mainly confined to tooth movement for impacted teeth, and Class II and Class III malocclusions, as well as for treatment of open bite cases. In particular the long term effects of correction of open bite with magnetic appliances have to be evaluated.