Anterior Open Bite Malocclusion Research Articles

An evaluation of cephalometric predictors of anterior open bite; An assessment of dental and skeletal parameters in an orthodontic population.

Anterior open bite (AOB) malocclusion is one of the highly challenging malocclusions. Cephalometric radiographs have been used for the diagnosis of occlusal anomalies in the vertical and anteroposterior directions. This study aims to compare skeletal and dental features in open and non-open bite subjects to identify factors that help predict and categorize open bites in a Nigerian population. Pretreatment cephalometric radiographs of 82 patients were recruited into this study. This study comprised 41 AOB patients and 41 (Class 1 malocclusion) patients (control group). The radiographs were obtained from the orthodontic unit, Department of Child Dental Health of the Lagos University Teaching Hospital, Idi-Araba Lagos. Cephalometric tracing and analysis of the obtained radiographs were used to identify and compare the skeletal and dental differences between the two groups. The mean age of the participants was 20.47 ± 8.05 years. The patients consisted of 26 (31.7%) males and 56 (68.3%) females. There was a significant difference in the open bite depth indicator (ODI) of the open bite (P value < 0.001). There was a statistically significant increase in the vertical skeletal parameters - lower facial height (LFH), total facial height (TFH), posterior facial height (PFH), Frankfort-mandibular plane angle (FMA), mandibular-maxillary angle (MMA), and gonial angle in the AOB group compared to the control group. The vertical height of the dentoalveolar segments measured was all significantly increased in the open bite group compared to the control group. The results suggest that the skeletal and dental vertical parameters, including ODI of the open bite subjects, varied compared with the non-open bite subjects in the Nigerian population studied and could be used to predict AOB tendency.

Anterior Open Bite Malocclusion: From Clinical Treatment Strategies towards the Dissection of the Genetic Bases of the Disease Using Human and Collaborative Cross Mice Cohorts.

Anterior open bite malocclusion is a complex dental condition characterized by a lack of contact or overlap between the upper and lower front teeth. It can lead to difficulties with speech, chewing, and biting. Its etiology is multifactorial, involving a combination of genetic, environmental, and developmental factors. Genetic studies have identified specific genes and signaling pathways involved in jaw growth, tooth eruption, and dental occlusion that may contribute to open bite development. Understanding the genetic and epigenetic factors contributing to skeletal open bite is crucial for developing effective prevention and treatment strategies. A thorough manual search was undertaken along with searches on PubMed, Scopus, Science Direct, and Web of Science for relevant studies published before June 2022. RCTs (clinical trials) and subsequent observational studies comprised the included studies. Orthodontic treatment is the primary approach for managing open bites, often involving braces, clear aligners, or other orthodontic appliances. In addition to orthodontic interventions, adjuvant therapies such as speech therapy and/or physiotherapy may be necessary. In some cases, surgical interventions may be necessary to correct underlying skeletal issues. Advancements in technology, such as 3D printing and computer-assisted design and manufacturing, have improved treatment precision and efficiency. Genetic research using animal models, such as the Collaborative Cross mouse population, offers insights into the genetic components of open bite and potential therapeutic targets. Identifying the underlying genetic factors and understanding their mechanisms can lead to the development of more precise treatments and preventive strategies for open bite. Here, we propose to perform human research using mouse models to generate debatable results. We anticipate that a genome-wide association study (GWAS) search for significant genes and their modifiers, an epigenetics-wide association study (EWAS), RNA-seq analysis, the integration of GWAS and expression-quantitative trait loci (eQTL), and micro-, small-, and long noncoding RNA analysis in tissues associated with open bite in humans and mice will uncover novel genes and genetic factors influencing this phenotype.

Class II and anterior open bite malocclusion treated with mini-implants, intermaxillary elastics, speech therapy, and retained with a night-wear palatal crib wraparound

The teeth position in anterior open bite malocclusion depends on a balance of pressure between the tongue and lips and the treatment planning should include such variables. The objective of this study was to report an orthodontic case of an adult with maxillary protrusion and anterior open bite treated with skeletal anchorage and intermaxillary elastics. The patient presented a Class II malocclusion with anterior open bite, without a history of non-nutritive habits, and mandibular missing teeth at 54 years old. Mini-implants were inserted in the maxillary molars region to produce distal movement of the maxillary dentition while controlling molar extrusion, and in the mandibular anterior region on the left side to produce mesial movement of posterior teeth. Up and down intermaxillary elastics were worn in the area of the incisors to treat the open bite together with Class II intermaxillary elastics. Cleats were bonded in the lingual surface of the anterior teeth as spurs to the tongue posture. However, the best result on the anterior open bite treatment was coincident with the speech therapy. Normal relationships between the maxillary and mandibular occlusal plane of cusps, correct anterior overbite, and adequate proximal relationships were obtained at the end of treatment. The retention modality to the maxillary arch was daily wear of a removable standard wraparound and a night-time wraparound with the palatal crib. The new technology allows for more effective treatment in adults and speech therapy was helpful to achieve balanced pressure between the tongue and lips.

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.

Root Resorption in Anterior Open Bite Malocclusions Due to Vertical Correction: A Radiometric Pilot Study

Root Resorption in Anterior Open Bite Malocclusions Due to Vertical Correction: A Radiometric Pilot Study

Mandibular morphometric analysis in open bite early treatment relapse subjects: a retrospective observational pilot study

BackgroundThe purpose of this retrospective study was to evaluate the mandibular shape differences between a group of success and a group of failure Anterior Open Bite (AOB) malocclusion early orthodontic treatment in growing subjects, in order to identify mandibular features of relapse.MethodsTwenty three patients (7 males, 16 females, 9.3 years ±1,5 years) were enrolled from the Department of Orthodontics at the University of Rome Tor Vergata. Inclusion criteria were: white ancestry, overbite < 0 mm, mixed dentition phase, end-to-end or Class I molar relationship, first skeletal class assessed on lateral cephalograms (0° < ANB < 4°), cervical skeletal maturation CS1-CS2, no previous orthodontic treatment, no congenital diseases. Pre-treatment (T1) lateral cephalograms were acquired. Each patient underwent early orthodontic treatment with Rapid Maxillary Expander (RME) and Bite Block (BB) or Quad-Helix Crib (QHC) until open bite correction. Radiographic records were recollected at T2 (permanent dentition, skeletal cervical maturation CS3-CS4). Mean interval time T2-T1 was 4.2 years ±6 months. According to treatment stability, a Relapse Group (RG 11 patients, 3 M, 8F; 13.7 years ±8 months, 7 subjects treated with RME/BB, 4 with QH/C) and a Success Group (SG, 12 patients, 4 M, 8F; 13.4 ± 10 months, 7 subjects treated with QH/C, 5 with RME/BB) were identified. On the lateral radiographs the mandibular length (Co-Gn), the inferior gonial angle (NGo^GoMe) and the antegonial notch depth (AND) were analyzed. Then the mandibular Geometric Morphometric analysis (GMM) was applied. Intergroup statistically significant differences were found using student’s t-tests. Procrustes analysis and principal component analysis (PCA) were performed for the GMM.ResultsAt T1 no statistically significant differences were found between RG and SG, however higher values of antegonial notch depth were found in RG. T2-T1 comparison showed in RG statistically significant increases in Co-Gn (p = 0.04), NGo^GoMe angle (p = 0.01) and antegonial notch depth (p = 0,04). PC1 confirmed the increase in the antegonial notch depth in RG when compared to SG at T2.ConclusionsThe increased antegonial notch depth associated with the increased mandibular length and the increased gonial angle could be responsible of relapse of early orthodontic treatment in open bite growing subjects.

Bias in the superimposition of lateral cephalograms in adult patients with anterior open bite

Anterior open bite malocclusion can be treated nonsurgically using fixed appliances, clear aligners, or temporary anchorage devices (TADs). Proponents of clear aligners and TADs often attribute bite closure to molar intrusion and counterclockwise rotation of the mandibular plane. These changes may be supported by superimpositions. However, the process of creating a superimposition is subjective and may be influenced by practitioner bias. The initial and final lateral cephalograms from 30 adult anterior patients with open bite were used in this study. Ten patients were treated with fixed appliances, 10 with clear aligners, and 10 with TADs. We asked 6 orthodontic graduate students and 6 orthodontic practitioners to complete superimpositions using these radiographs in 3 separate sessions. In the first session, the raters were told that all patients only received treatment with fixed appliances. In the second session, the raters were told that all patients were treated with clear aligners only, and in the third session, they were told all patients were treated with fixed appliances and TADs. Superimpositions were performed using Dolphin software, and each superimposition was saved as a Portable Document Format image. Change in the mandibular plane was the primary outcome and was assessed categorically (closed, no change, opened). Cephalometric values were measured and used to investigate the dental and skeletal changes associated with treatment. Although the raters demonstrated a slight tendency toward the mandibular plane closing or staying the same when told the treatment was clear aligners or TADs, these differences were not statistically significant. A high degree of intrarater and interrater variability in the mandibular plane change was present in all 3 superimposition sessions. The measurements from the lateral cephs showed significant changes for overbite and incisor vertical and angular movements. Almost no change was observed in anterior facial height, mandibular plane angle, or vertical movement of the first molars. This study did not observe a significant amount of superimposition bias. However, there was considerable intrarater and interrater reliability. This suggests that the same initial and final cephs may be interpreted very differently on the basis of the subjective superimposition of the raters.

Contextual and Individual Determinants of Anterior Open Bite in Adolescents

ObjectiveStudying the broader determinants of anterior open bite (AOB) may guide more equitable policies.This study estimates the prevalence of AOB in Brazilian adolescents and its association with contextual and individual determinants. MethodologyThe data for dentofacial anomalies in 15- to 19-year-olds from the National Oral Health Survey SBBrasil 2010 were analysed (N = 4748). AOB was based on the Dental Aesthetic Index (AOB = 0; AOB > 0); the contextual variables were the Human Development Index (HDI) and the Gini Index (2010). The individual sociodemographic variables included sex (male, female), self-reported skin colour/race (white, black, brown, and indigenous + yellow), family income (≥4 minimum wage [MW]; 0–3 MW), and educational attainment (ideal, delayed). The individual clinical variables were decayed, missing, and filled teeth (DMFT) (0, ≥1), first permanent molar loss (0, ≤3, 4), and molar relationship (normal, half cusp, full cusp). Multilevel logistic regression models with random intercepts and fixed slopes were used to estimate odds ratios (ORs) and confidence intervals (95% CIs). ResultsAOB prevalence in Brazil was 8.78% (95% CI, 6.85–11.20) at 15 to 19 years of age. The lowest prevalence was in São Luis (2.63%; 95% CI, 0.58–11.03) and the highest was in João Pessoa (29.85%; 95% CI, 15.93–48.85), both capitals of the northeast Brazilian region. A higher prevalence of AOB (OR, 1.71; 95% CI, 1.04–2.80) was observed in municipalities with a lower HDI. Adolescents who declared their skin colour black, with lower family income, with delayed education, with DMFT ≥ 1, who lost 4 permanent first molars, and who had a complete molar cusp relationship were more likely to have AOB. ConclusionsAOB varied amongst Brazilian municipalities. The HDI plays an important role in the prevalence of AOB; individual social determinants have also been associated with AOB malocclusion in adolescents.

Gastric emptying rate of a solid meal in patients with anterior open bite malocclusion: A preliminary study

Objectives: The objective of the study was to investigate the relationship between anterior open bite (AOB) malocclusion and digestion by evaluating mastication and gastric emptying (GE) of a solid meal. Material and Methods: We recruited 26 female participants and divided them into two groups according to their occlusion status: The control group with normal occlusion (n = 11; age: 25.2 ± 2.8 years; and body mass index [BMI]: 21.1 ± 1.9 kg/m2) and the AOB group with AOB malocclusion (n = 15; age: 23.2 ± 5.5 years; BMI: 21.0 ± 1.6 kg/m2). GE, chewing, and occlusion were assessed simultaneously. A food questionnaire survey was also administered on the same day. Results: A significant positive correlation was noted between open bite and the occlusal analysis findings. Negative correlations were found between the food questionnaire score and both the open bite and occlusal analysis findings, which confirmed that AOB affects mastication. However, no significant difference in the GE rate parameters was observed between the two groups. Conclusion: Adaptive mechanisms may have a compensatory effect on the GE rate. However, the lack of tooth contact in the anterior occlusal region resulted in reduced masticatory ability. Orthodontic treatment should thus be considered, regardless of the presence of digestive problems, to improve mastication.

Is Orthognathic Correction with TMJ Preservation A Stable Treatment Option for Patients with Juvenile Idiopathic Arthritis?

The purpose of this study was to evaluate the long-term skeletal stability of orthognathic correction of dentofacial deformities secondary to juvenile idiopathic arthritis (JIA) in individuals without total alloplastic joint reconstruction. The investigators designed and implemented a retrospective case series of patients diagnosed with JIA who underwent bimaxillary orthognathic surgery. To evaluate the long-term skeletal changes, the maxillary palatal plane to mandibular plane angle, anterior facial height, and posterior facial height measurements were evaluated through cephalograms. Six patients met inclusion criteria. All subjects were female (mean 16.2years). Four patients demonstrated < 1° of change of the palatal plane to mandibular plane angle, and all patients had < 2° of change. Three patients had < 1% change in the anterior to posterior facial height ratio. Three patients demonstrated relative posterior facial shortening compared to anterior facial height (< 4%). No patients developed postoperative anterior open-bite malocclusion. Orthognathic correction of the JIA DFD deformity with TMJ preservation is a viable modality to improve facial esthetics, occlusion, upper airway and speech swallowing and chewing mechanisms in select patients. The measured skeletal relapse did not affect the clinical outcome.

A case of camouflage orthodontic treatment in a bilateral cleft lip and palate patient with skeletal class III and anterior open bite malocclusion

A case of camouflage orthodontic treatment in a bilateral cleft lip and palate patient with skeletal class III and anterior open bite malocclusion

Anterior openbite malocclusion in adults.

To investigate stability and satisfaction in adult anterior open bite (AOB) patients at least 9 months post-treatment, as well as patient and practitioner factors that may be associated with stability and satisfaction. Practitioners and their adult AOB patients were recruited through the National Dental Practice-Based Research Network. Data on patient and practitioner characteristics, treatment recommendations and factors were previously collected. Treatment stability was determined by assessing post-treatment intraoral photographs. Patient satisfaction was determined from post-treatment questionnaires. Treatment was categorized into aligners, fixed appliances, temporary anchorage devices, and orthognathic surgery. Extractions were also investigated. Retention type was categorized into vacuum-formed, Hawley-style, or bonded retainers, and regimens were classified as full-time or part-time wear. Retention data collected from 112 patients had a mean post-treatment time of 1.21 years. There were no statistically significant differences in stability between treatment groups. Depending on whether a qualitative index or a millimetric measure was employed, stability ranged from 65% to 89%. Extractions and less initial lower incisor proclination were associated with higher stability in patients treated with fixed appliances only. High satisfaction was reported by patients at retention. There were no clear differences in stability or satisfaction among retention types or regimens. The stability of adult AOB orthodontic treatment was high, regardless of treatment or retainer modality. Satisfaction in adult AOB patients was high, regardless of retention type or regimen.

Three-dimensional volumetric evaluation of dental pulp cavity/tooth ratio in anterior open bite malocclusion using cone beam computed tomography.

To assess and compare pulp cavity/tooth volume ratio of maxillary permanent teeth between patients exhibiting anterior open bite malocclusion and those exhibiting anterior normal overbite using cone beam computed tomography (CBCT). 3D dental images from 44 patients aged between 15 and 29years were analyzed. The DICOM files of all dental images were imported into an image processing software for calculating pulp cavity volume and tooth volume. Differences of pulp cavity volume, tooth volume, and pulp cavity/tooth volume ratio of each tooth type from both types of occlusions were analyzed using the independent t test. The intra-class correlation coefficient was used to evaluate intra-examiner reliability. The means of pulp cavity/tooth volume ratio in anterior open bite group were significantly greater than those in anterior normal overbite group (central incisor p = 0.001; lateral incisor p = 0.00025 and canine p = 0.004). The means of root canal/root volume ratio in anterior open bite group were significantly greater than anterior normal overbite group (central incisor p = 0.00001; lateral incisor p = 0.00007; and canine p = 0.001), whereas there were no significant differences of the means of pulp chamber/crown volume was observed. Anterior open bite malocclusion might lead to an increase of the pulp cavity volume and decrease of the tooth volume due to occlusal hypofunction. Orthodontic force should be carefully determined in anterior open bite patient due to the greater root canal volume and lesser root volume.

The open bite checklist manifesto

Background and Purpose: The vertical problems and specifically the anterior open bite (AOB) malocclusion represent a challenging situation whenever they are encountered by an orthodontist. The multiple intervening etiologies, the skeletal dysplasia involved, the functional and esthetic problems contribute to the difficulty of the situation. AOB is a descriptive term; underneath which lies a variety of antithesis status that depicts a similar overall appearance. An astute orthodontist should be able to look beyond the overall image to identify the etiological factor(s) that caused such malocclusion and consider the contributing components to apply the appropriate treatment modality. The aim of this paper is to study the interaction between the various components contributing to the AOB malocclusion.Methods: A subclassification has been proposed based on how these components present together differently (whether skeletal or dental open bites). A checklist of 10 questions has been formulated. The answers to these 10 questions in sequence were used through a specifically constructed diagnostic tree that should guide the orthodontist toward an accurate diagnosis.Results: The checklist and diagnostic tree were successfully applied on five patients, which is thought to facilitate their treatment planning.Conclusions: The detailed classification was useful in giving an idea on the clinical and cephalometric features of each patient. The checklist and the diagnostic tree helped to identify the exact offending factors for the presenting malocclusion. Accordingly, the most appropriate treatment option would be provided.

The National Dental Practice-Based Research Network Adult Anterior Open Bite Study: Patient satisfaction with treatment

This article evaluates and reports on the satisfaction of adult patients across the United States who received orthodontic treatment for anterior open bite malocclusion. The factors that influence satisfaction are also described. Practitioners were recruited from the National Dental Practice-Based Research Network. On joining the Network, practitioner demographics and information on their practices were acquired. Practitioners enrolled their adult patients in active treatment for anterior open bite. Patient demographics, patient dentofacial characteristics, and details regarding previous and current treatment were collected through questionnaires at enrollment (T1). Pretreatment lateral cephalograms and intraoral frontal photographs were submitted. Treatment performed, and details related to treatment outcome were recorded through questionnaires at the end of active treatment (T2). Posttreatment lateral cephalograms and intraoral frontal photographs were submitted. Patient satisfaction at T2 was assessed using a 5-point Likert-type scale and open-ended responses. Predictive univariate models were developed to evaluate the factors that affect patient satisfaction. Open-ended responses were reviewed for general trends. T2 data were received for 260 patients, and 248 of these patients completed and returned the patient satisfaction questionnaires. High levels of satisfaction were found in this sample of adult patients receiving treatment for anterior open bite malocclusion. Specifically, 96% of the sample reported being very or somewhat satisfied. Only 10 patients (4%) were not satisfied with the treatment provided or an element of the final result. Successful open bite closure, treatment modality, and certain patient characteristics may affect patient satisfaction. However, there was insufficient power to demonstrate statistical significance because of the very low number of dissatisfied patients. Open-ended responses directly associated with patient satisfaction were received from 23 patients (9%). They relayed positive, neutral, and negative feelings about the treatment received and final results. Additional responses regarding the orthodontic treatment in general, but not specifically linked to patient satisfaction, were received from 119 patients (48%). These comments depict an overwhelmingly positive experience. Adult patients who received orthodontic treatment for anterior open bite malocclusion were generally satisfied with the treatment provided, as well as the final esthetic and functional results.

Dentoskeletal changes in open bite treatment using spurs and posterior build-ups: A randomized clinical trial

This single-center 2-arm parallel randomized clinical trial aimed to compare the dentoskeletal effects of bonded spurs combined with posterior build-ups vs conventional bonded spurs in the treatment of anterior open bite malocclusion in the mixed dentition. Patients aged from 7 to 11years with anterior open bite, recruited at a university orthodontic clinic, were randomly allocated into 2 groups. The experimental group consisted of patients treated with bonded spurs combined with posterior build-ups. The comparison group comprised patients treated with conventional bonded spurs. Lateral headfilms were obtained at pretreatment and after 12months of treatment. The primary outcome was the change in the overbite. Randomization was performed using the Web site www.randomization.com. Sequentially numbered opaque and sealed envelopes were used for allocation concealment. Blinding was applicable for outcome assessment only. Intergroup comparisons were performed using t or Mann-Whitney U tests (P<0.05). Mean difference (MD) and 95% confidence interval (CI) were obtained. The experimental group included 24 patients (17 female, 7 male; mean age, 8.22±1.06years) and the comparison group comprised 25 patients (14 female, 11 male; mean age, 8.30±0.99years). Baseline demographic and cephalometric characteristics were similar between groups. After 12months, all patients showed improvements. Both groups showed similar improvements of the overbite (MD, 0.00mm; 95% CI, -0.92 to 0.91), similar slight decreases of the gonial (MD, 0.02°; 95% CI, -1.11 to 1.15) and mandibular plane (MD, 0.15°; 95% CI, -0.64 to 0.93) angles, and similar mandibular molar extrusion (MD, 0.14mm; 95% CI, -0.27 to 0.56). The experimental group showed significantly smaller extrusion of the maxillary first molar than the comparison group (MD, -0.70mm; 95% CI, -0.92 to -0.49). The other dentoskeletal variables showed similar changes without statistically significant intergroup differences. No serious harm was observed other than plaque accumulation around the spurs. Similar overbite increases and dentoskeletal changes were observed in both groups after 12months of treatment. Although the experimental group showed significantly smaller extrusion of the maxillary molars, no greater counterclockwise rotation of the mandible than the comparison group was observed. This trial was registered at Clinicaltrials.gov (Identifier NCT03702881). The protocol was not published. This trial was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES), Finance Code 001; and by grants: no. 2017/06440-3, no. 2018/05238-9 and no. 2018/24003-2, São Paulo Research Foundation (FAPESP).

Skeletal morphologic features of Anterior Open Bite Malocclusionamongst black patients visiting the Medunsa oral health centre

INTRODUCTION: Anterior open bite (AOB) malocclusion presents as lack of vertical overlap of anterior teeth. It is viewed to be unaesthetic and may affect speech and mastication It develops due to the interaction of hereditary and environmental etiological factors and these usually affect the vertical growth of the face. This study describes the vertical changes of South African black people presenting with AOB. AIMS AND OBJECTIVES: The aim was to determine skeletal morphological features of patients with AOB malocclusion. DESIGN: The design was a retrospective, cross-sectional study. MATERIALS: Archived pre-treatment lateral cephalographs of 181 patients who consulted between 2007 and 2014 were divided into four groups: control group of 62 patients with skeletal Class I pattern without AOB; test groups of patients with AOB (119) divided into 35 Class I, 43 Class II, and 41 Class III malocclusions. Records of each group were divided according to gender. Descriptive statistics, the Pearson correlation coefficient, t-test and. Wilcoxon test were employed to analyze the data, and p values of &lt;0.05 were considered statistically significant. RESULTS AND CONCLUSIONS: Patients with AOB had a larger vertical facial pattern in all classes of malocclusion. Males presented with larger Sn-GoGn angles than females. The PFH/AFH ratio was lower across all classes of malocclusion compared to the control group.

Treatment of anterior open-bite using zygomatic anchorage: a 10-year follow-up case report

Abstract Aim To present the treatment and long-term post-treatment results of an adult case presenting with an Angle Class II anterior openbite malocclusion that involved the use of zygomatic anchorage for the intrusion of the maxillary posterior teeth. Methods A 23-year-old female patient with a bilateral Angle Class II molar and canine relationship, a 4 mm overjet and a 6 mm anterior open-bite was treated using zygomatic anchorage in order to correct the dental and skeletal relationships, and eliminate the anterior open-bite to achieve an ideal overjet, overbite and improved facial aesthetics. Orthodontic brackets were placed on the maxillary and mandibular teeth. Under local anaesthesia, a subperiosteal flap was raised, and two titanium miniplates were bilaterally placed in the zygomatic area. The molars were intruded by applying 400 grams of force to the miniplates via connection to the upper arch wire. Results By intruding the molar teeth using zygomatic anchorage, the anterior open-bite was corrected to achieve an Angle Class I occlusion, an ideal overbite and a harmonious facial profile that were successfully maintained after a 10-year follow-up period.

Correction of Anterior Open Bite Malocclusion with the Association of Removable Palatal Crib and Chincup

AbstractAnterior open bite affects the child population by approximately 20%, with great aesthetic-functional impairment due to dental-skeletal changes, which may involve the presence of posterior crossbite. The objective was to present the anterior open bite correction associated with posterior crossbite with the use of a removable palatal crib. Patient during the mixed dentition phase presented an anterior open bite caused by a pacifier sucking habit and secondary lingual interposition. The treatment protocol consisted of the use of removable expander with palatal crib and nocturnal use of the chincup. The anterior open bite was corrected, and the best transverse relation of the arches was obtained. The precocious treatment using the palatal crib associated to the chincup allows to achieve favorable results in the resolution of the anterior open bite. Keywords: Open Bite. Malocclusion. Orthodontics, Interceptive. ResumoA mordida aberta anterior acomete a população infantil em aproximadamente 20%, com grande comprometimento estético-funcional em decorrência das alterações dentoesqueléticas, podendo envolver a presença de mordida cruzada posterior. O objetivo do estudo foi apresentar a correção da mordida aberta anterior associada à mordida cruzada posterior com a utilização de grade palatina removível. Paciente em fase de dentadura mista, apresentava mordida aberta anterior ocasionada por um hábito de sucção de chupeta e interposição lingual secundária. O protocolo de tratamento consistiu na utilização de expansor removível com grade palatina e uso noturno da mentoneira. A mordida aberta anterior foi corrigida e melhor relação transversal dos arcos foi obtida. O tratamento precoce utilizando grade palatina associada à mentoneira permite alcançar resultados favoráveis na resolução da mordida aberta anterior. Palavras-chave: Mordida Aberta. Má Oclusão. Ortodontia Interceptora.

Nonsurgical treatment and stability of an adult with a severe anterior open-bite malocclusion.

OBJECTIVES:A skeletal anterior open-bite is a challenging malocclusion for the orthodontist due to the difficulty and instability of correction. Treatment options for the adult patient include extractions, anterior extrusion with intermaxillary elastics, posterior intrusion using skeletal anchorage, occlusal adjustment, and orthognathic surgery. Patient compliance plays a key role in posttreatment stability. The present case report demonstrates the orthodontic treatment of an adult patient who presented with a complex open-bite malocclusion.MATERIALS AND METHODS:Treatment involved the placement of four miniscrews to assist intrusion of maxillary molars by applying posterior vertical maxillary elastics and extrusion of the anterior segments using anterior vertical interarch elastics.RESULTS:Ideal intercuspation was successfully achieved and good stability was maintained during 3 years following treatment.CONCLUSION:The intrusion of the maxillary molars with miniscrews is an interesting option in selected cases of skeletal anterior open bite. The retention protocol should be specific in these cases.