Open Bite Research Articles

Camouflage Correction of Skeletal Class III Severe Open Bite with Tooth Ankylosis Treated by Temporary Anchorage Devices: A Case Report

Tooth ankylosis is a disorder characterized by the fusion of tooth and alveolar bone. This case report describes the treatment of a severe open bite due to tooth ankylosis. A 14-year-old female patient with a chief complaint of masticatory dysfunction was diagnosed with skeletal Class III severe anterior open bite and tooth ankylosis. She visited our university hospital with a chief complaint of an anterior open bite. After the surgical luxation of the ankylosed maxillary right central incisor, the tooth was orthodontically retracted using a nickel-titanium wire. The right mandibular lateral incisor and canine were luxated and retracted using intermaxillary elastics from a temporary anchorage device (TAD), which was inserted in the opposite jaw. During the treatment, skeletal Class III malocclusion deteriorated due to anterior growth of the mandible. Therefore, TADs were inserted into the retromolar pad on both sides of the mandible and retracted into the mandibular dental arch. Although the mandibular right canine was luxated several times, it could not be brought to the occlusal line, and was thus extracted; the extraction space was replaced with a prosthesis. Consequently, a normal overjet and overbite with a straight profile were achieved. Extrusion of ankylosed teeth by intermaxillary elastics from a TAD is a valid treatment option for patients with severe open bites.

Anterior open bite self-correction after cessation of non-nutritive sucking habits: a systematic review.

Non-nutritive sucking habits likely may cause occlusal changes such as anterior open bite (AOB) if they persist over extended time. To assess if there is self-correction of AOB after cessation of non-nutritive sucking habits in children older than 4 years old, through a systematic review. Data sources included PubMed, Scopus, Web of Science and Latin American and Caribbean Health Sciences (LILACS) databases, gray literature as Google Scholar, the database System for Information on Gray Literature in Europe (OpenGrey) and ProQuest Dissertations and Theses Database, also hand searches of the included studies references. Studies assessing occlusal changes in children aged 4-12 years with AOB traits and non-nutritive sucking habits after the discontinuation of the habit were included. Two authors independently assessed eligibility and extracted data. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale and the Joanna Briggs Critical Appraisal Checklist for quasi-experimental studies. The confidence in cumulative evidence was assessed using the GRADE criteria. Over 3100 studies, only 5 met the inclusion criteria. There is often self-correction of AOB after discontinuing the non-nutritive sucking habit, even in cases older than 4 years old. The improvement ranged between 50 and 100%. The overall quality of evidence was very low. AOB self-correction after discontinuing a non-nutritive sucking habit is possible, even after 4 years old, although with very low certainty in the body of evidence. It is not clear after what age the removal from the habit is unlikely to facilitate AOB self-correction. International Prospective Register of Systematic Reviews code: CRD42016052171. There was no conflicting interest from the review authors.

The Impact of Benign Jawbone Tumors on the Temporomandibular Joint and Occlusion in Children: A Ten-Year Follow-Up Study

This study aimed to provide a complex analysis of the modifications in craniofacial skeleton development that may arise following the diagnosis of pediatric benign jaw tumors. A prospective study was undertaken involving 53 patients younger than 18 years of age, who presented for treatment at the Department of Maxillo-Facial Surgery, University of Medicine and Pharmacy, Cluj-Napoca, with a primary benign jaw lesion between 2012 and 2022. A total of 28 odontogenic cysts (OCs), 14 odontogenic tumors (OTs), and 11 non-OTs were identified. At follow-up, dental anomalies were identified in 26 patients, and overjet changes were found in 33 children; lateral crossbite, midline shift, and edge-to-edge bite were found in 49 cases; deep or open bite were found in 23 patients. Temporomandibular disorders (TMDs) were found in 51 children, with unilateral TMJ changes identified in 7 cases and bilateral modifications found in 44 patients. Degenerative changes in the TMJ were also diagnosed in 22 pediatric patients. Although benign lesions could be associated with dental malocclusions, a direct etiological factor could be not identified. The presence of jaw tumors or their surgical treatment could, however, be linked to a change of the occlusal relationships or the onset of a TMD.

Surgical-Orthodontic Treatment of Class III Malocclusion with Anterior Open Bite

A 21-year-old female came with chief complaints of inability to incise food and poor esthetics. The patient presented with a concave facial profile, long face with a steep mandibular angle, incompetent lip closure, and acute nasolabial angle. Intraorally, she had negative 6 mm overjet, 3 mm open bite and dental crowding. She was diagnosed as severe skeletal Class III malocclusion and anterior open bite. The treatment plan included orthodontic treatment with orthognathic surgery and extraction of maxillary second molars, which were supra-erupted and tipped buccally. The pre-operative orthodontic alignment took 11 months. The surgical correction included maxillary Le Fort I osteotomy with 4 mm advancement, mandibular intraoral vertical ramus osteotomy with 6.5 mm setback and genioplasty. The total surgical-orthodontic treatment time was 16 months. The final result presented a straight profile with stable occlusion. The patient’s facial and dental esthetics, masticatory function, and quality of life were all significantly improved after surgical-orthodontic treatment.

Prevalence and Associated Factors of Malocclusion among Preschool Children in Huizhou, China: A Cross-Sectional Study.

This survey examined the prevalence of malocclusion and its associated factors in 3- to 5-year-old children in Huizhou, China. Children were recruited from 21 kindergartens using a multistage sampling method. Two examiners performed oral examinations on the children, assessing occlusal traits, including primary molar and canine relationship, overjet, crossbite, overbite, anterior open bite, scissor bite, midline deviation, crowding, and spacing. Caries experience was recorded. Self-administered questionnaires were distributed to collect background information and oral health-related habits. Chi-square test, Mann-Whitney U test, and binary logistic regression were conducted. The study invited 1485 children and eventually recruited 1454 (52.9% boys; response rate: 97.9%). The prevalence of malocclusion was 68.3%, and deep overbite was found in 48.6% of the children. Children who had lip-biting habits had a higher prevalence of deep overbite than those who did not (OR = 2.36, p < 0.05). Children who had digit-sucking habits and dental caries in anterior maxillary teeth had a lower prevalence of deep overbite than those who did not (OR = 0.73 and 0.70, respectively, p < 0.05). In conclusion, over half of the children in Huizhou who participated in the study had malocclusion. Dental caries in anterior maxillary teeth, digit-sucking, and lip-biting were the associated factors of deep overbite.

Non-Surgical Camouflage Treatment of a Skeletal Class III Patient with Anterior Open Bite and Asymmetry Using Orthodontic Miniscrews and Intermaxillary Elastics

This case report presents the non-surgical orthodontic camouflage treatment of an 18-year-old male patient with skeletal Class III asymmetry and severe anterior open bite. The anterior open bite was corrected by extrusion of the maxillary and mandibular anterior teeth and clockwise and counterclockwise rotation of the maxillary and mandibular occlusal plane, respectively, using intermaxillary Class III elastics between the maxillary posterior buccal miniscrews and mandibular canines and anterior vertical elastics between the maxillary and mandibular canines. Class III dental relationships and dental asymmetry were corrected via unilateral distalization of the mandibular dentition on the left side using a closed coil spring between the buccal shelf screw and hook. The patient’s smile esthetics and dental relationship were improved with a more favorable facial profile, and facial asymmetry was slightly alleviated after orthodontic camouflage treatment. The total treatment time was 15 months. A modified wraparound retainer with a scalloped labial bow, tongue crib, and tooth positioner was used simultaneously to prevent the potential relapse.

Treatment of an Open Bite Patient with Maxillary Expansion and Micro-Implant Anchorage

The purpose of this case report was to describe the treatment of an open bite patient with palatal expansion and micro-implant anchorage. A 21-year-old female presented with a chief complaint of openbite. Clinical examination showed straight profile with mild crowding. Intraorally, she exhibited both Class I molar relationship, 1.5 mm negative overbite. Due to the transverse discrepancy, upper molars were palatally tipped, while lower molars were buccally tipped. The maxillary arch expansion was performed using rapid palatal expander. After maxillary expansion, orthodontic micro-implants were used for upper molars intrusion. After orthodontic treatment, the patient showed proper overjet and overbite, and good retention after 2 years. Open bite can be corrected by counterclockwise autorotation of the mandible obtained with intrusion of molars and it is critical to eliminate the causative agent.

Corrigendum to ‘Treatment of a Skeletal Class II Openbite Malocclusion Using Modified Boned TPA’

Corrigendum to ‘Treatment of a Skeletal Class II Openbite Malocclusion Using Modified Boned TPA’ [Clin J Korean Assoc Orthod 2022;12(1):53-62, https://doi.org/10.33777/cjkao.2022.12.1.53] 의 이용 수, 등재여부, 발행기관, 저자, 초록, 목차, 참고문헌 등 논문에 관한 다양한 정보 및 관련논문 목록과 논문의 분야별 BEST, NEW 논문 목록을 확인 하실 수 있습니다.

Replantation of autotransplanted mature third molar in anterior open bite patient: case report

Replantation of autotransplanted mature third molar in anterior open bite patient: case report

Case series of drug-induced open bite: Extrapyramidal symptoms related to psychotropic medications.

Drug-induced open bite is one of the extrapyramidal symptoms with abnormal tonus of muscles and is rarely recognized in dentistry. This is a retrospective case study to investigate clinical characteristics including detailed complaints in patients with drug-induced open bite. Of the outpatients who first visited the psychosomatic dental clinic at the Tokyo Medical and Dental University Hospital between September 2013 and September 2022, the patients diagnosed with drug-induced open bite were involved in this study. The clinical characteristics including sex, age, detailed complaints, duration of illness, abnormal findings, psychotropic medications, and other medications that were taken at the first examination, psychiatric comorbidities, the duration of psychiatric diseases, and other medical histories were collected retrospectively by reviewing their medical chart. Drug-induced open bite was found in 11 patients [women: 7, men: 4, median of age: 49 (36.5, 53) years old]. Difficulty in eating especially chewing was the major complaint (9/11, 81.6%) with the duration of illness as 48.0 (16.5, 66) months. Various degrees of open bite were observed. While some showed no occlusal contact on frontal teeth, some showed occlusal contact only on the second molars; moreover, the jaw showed a horizontal slide in a few patients. Three cases could be followed up for prognosis; while in one case the drug-induced open bite improved with 6 months of follow-up, two cases did not improve, and one showed extrusion of molars. All of them had psychiatric comorbidities with the most common diagnosis being schizophrenia (n = 5) and depression (n = 5) followed by insomnia (n = 1) and autism spectrum disorder (n = 1) including duplicated diagnosis. Nine patients (81.6%) had been undergoing treatment with antipsychotics of which three patients were also taking antidepressants. Although a drug-induced open bite is a rare symptom, prudent medical interviews about symptoms, psychiatric comorbidities, and psychotropic medication history besides oral assessment are necessary to provide a precise diagnosis and appropriate management in collaboration between dentists and psychiatrists.

Orthognathic Surgery as Class III Skeletal Treatment in a 31-Year-Old Female with Mandible Prognathism: A Case Report.

Mandible prognathism or malocclusion skeletal class III is facial deformities. These deformities can affect orofacial function, such as mastication, speech, and function of the temporomandibular joint. Besides the physical effects of these deformities, the psychosocial impact on the individual is often essential, and such deformities can affect the quality of life and self-confidence. Orthognathic surgery is designed to correct these deformities because these deformities could not have been corrected by only orthodontic treatment. Therefore, at Hasan Sadikin General Hospital, orthognathic surgery is the treatment choice for mandibular prognathism or malocclusion skeletal class III. In this case report, we present a 31-year-old female with mandibular prognathism, difficulty in closing her mouth and anterior open bite. Surgery was performed by Le Fort 1 osteotomy for advancing maxilla and bilateral sagittal split osteotomy for setback mandible. Two weeks after surgery, patient came back to the orthodontic department for occlusion treatment.

Adaptability of the tongue during orthodontic apparatus treatment

To date, most dentoalveolar deformities are associated with bad habits such as thumb sucking, tongue sticking out, and so on. According to the authors, protrusion of the tongue is normal in newborns, in which the tongue lies between the gingival pads, and the lower jaw is stabilized by the facial muscles during swallowing. With the eruption of temporary teeth, this physiological phenomenon disappears. The authors pointed out that there are such concepts as «simple tongue push» and «complex tongue push». The first relates to open bite push-outs. The second is observed in children with an open bite, as well as with respiratory complications and / or with a history of chronic diseases of the nasopharynx. The act of swallowing in the physiological sense is divided into 3 stages: oral, pharyngeal and esophageal. Each stage is characterized by different positions of the tongue in the oral cavity. Orthodontic hardware treatment of such patients is aimed at eliminating these habits, as well as correcting the bite. Although many studies have been conducted since 1965, to this day, aimed at studying the tongue protrusion in infantile swallowing, as well as in various malocclusion deformities, the authors found that these studies have shortcomings. For each patient, the shape, size, as well as the trajectory of movements may vary due to anatomical features (short frenulum of the tongue). In this review article, the authors consider such concepts as the adaptive ability of the tongue during infantile swallowing, as well as its trajectory of movements when using various methods of hardware treatment; various orthodontic devices for the treatment of tongue misalignments, their components and their purposes are described. The current classification, main characteristics of this pathological condition and its connection with the dentoalveolar system are considered. Based on the study, it can be concluded that there are several directions in the treatment of infantile swallowing. One of these areas is hardware treatment in the form of the use of plates with a flap for the tongue.

Management of moderate crowding by two-arch distalization using passive self-ligating lingual brackets, in-house digital indirect bonding, and mini-screw anchorage: A case report

This case report presents the management of an adult patient with moderate crowding in both arches and anterior crossbite with passive self-ligating lingual brackets. The orthodontic setup and bracket positioning was done digitally with an in-house approach. Virtual setup and bracket placement was performed on Autolign software (Diorco, Gyeonggi-do, Korea). The indirect bonding trays were vacuum-formed on printed malocclusion models with resin brackets. Two palatal and two buccal shelf miniscrews were used for two-arch distalization to correct proclined incisors and anterior open bite after leveling and alignment stage. After 12-month treatment, normal overbite,overjet and well-aligned dentition were achieved without premolar extraction. The incisors were uprighted slightly and the protrusive lower lip was retracted with improvement of facial harmony. One-year retention records confirmed that the outcome was stable. In-house digital setup and bracket placement could be a cost-effective approach for indirect lingual bracket bonding. Two-arch distalization with miniscrew anchorage may have the possibility of managing moderate crowding cases without premolar extraction or interproximal stripping.

Traditional and Modern Approaches in the Treatment of Skeletal Class II Malocclusion associated with a Severe Skeletal Open Bite: A Case Report

Traditional and Modern Approaches in the Treatment of Skeletal Class II Malocclusion associated with a Severe Skeletal Open Bite: A Case Report

Association of breastfeeding duration with the development of non-nutritive habits, and transversal and vertical occlusal alterations in preschool children: A cross-sectional study.

Breastfeeding has multiple nutritional, immunological and psychological benefits, as well as a positive influence on the development of the stomatognathic system. The present study attempted to determine the relationship between the duration of breastfeeding and the development of non-nutritive habits, and transversal and vertical occlusal alterations in preschool children. This cross-sectional study involved 155 preschoolers aged 2-5 years from 3 public schools in Lima, Peru. The sample was divided into 2 groups with regard to the duration of breastfeeding: group A (n = 50) included infants that had been breastfed for up to 6 months; and group B (n = 105) included infants that had been breastfed for 6-12 months. Two trained and calibrated dentists evaluated each group, and clinically determined the presence or absence of transversal or vertical occlusal alterations. Likewise, the children's parents or caregivers were consulted to determine the development of non-nutritive habits. A significant association was found between breastfeeding duration and the development of the oral breathing habit; groups A and B showed a prevalence of 30.0% and 16.2%, respectively (p = 0.048). Likewise, breastfeeding duration affected the appearance of oral breathing (OR (odds ratio) = 0.84; 95% CI (confidence interval): 0.74-0.96; p = 0.011). Furthermore, the use of a bottle for more than 24 months significantly influenced the appearance of oral habits (OR = 3.55; 95% CI: 1.20-10.55; p = 0.022) and open bite (OR = 12.12; 95% CI: 1.16-126.31; p = 0.037). Breastfeeding duration of 6-12 months was shown to be a protective factor in preventing the appearance of oral breathing. Posterior crossbite (PCB), open bite and deep bite seemed not to be influenced by breastfeeding duration. However, the use of a bottle for more than 24 months significantly influenced the appearance of anterior open bite.

Can Condylectomy Alone Achieve Facial Symmetry in Patients With Hemimandibular Hyperplasia (Condylar Hyperplasia Type 2)?

The purpose of the present study was to evaluate the 3-dimensional orofacial changes occurring after proportional condylectomy in patients with unilateral condylar hyperplasia type 2 (hemimandibular hyperplasia). Eight patients underwent proportional condylectomy that was not followed by orthognathic surgery or orthodontic treatment for at least 1 year. The precondylectomy and postcondylectomy photographs and radiographs were analyzed cephalometrically and compared. The average length of the condylar segment removed was 13mm and this resulted in almost equal heights of the ramus-condyle units of both sides. Evaluations in the vertical plane improved after surgery; however, when the preoperative asymmetry was significant, the residual asymmetry continued to be notable after condylectomy. Transverse plane evaluations improved after condylectomy, and chin position was satisfactorily centralized in all patients. In the horizontal plane, mandibular setback occurred, and this was considered favorable when the preoperative skeletal profile was class III, whereas the opposite was when the patient was class I before surgery. The occlusion improved gradually over the postoperative months by the intrusion on the affected side and extrusion on the unaffected side into a bilaterally balanced posterior contacts with residual anterior open bite. In conclusion, condylar hyperplasia type 2 patients with mild asymmetry and low esthetic demands can benefit from proportional condylectomy as the sole treatment to both stop the hyperplastic condylar growth and improve the asymmetry to some extent. Surgeons should be able to predict the change that is expected to occur after proportional condylectomy and discuss this with the patient before surgery.

Understanding the relationship between orofacial structures and feeding habits of preschoolers: A multivariate analysis.

The understanding of the relationship between orofacial structures and feeding habits in preschoolers is helpful for health professionals and those dedicated to food science. The hypothesis tested was whether this relationship is already present even at a very young age. This cross-sectional study included 91 healthy caries-free children (50 girls/41 boys; 3.4-6.2 years; mean 4.1 years) and a comprehensive evaluation of the stomatognathic system was performed: dietary intake, facial and occlusal morphology, gustatory sensitivity, bite and lip forces, and orofacial myofunctional aspects (mastication, swallowing and breathing functions). Principal component analysis summarized the variables related to the form and function of the orofacial aspects; further, K-means analysis identified two clusters of participants with similar aspects. Cluster 1 ("Low orofacial myofunctional functioning"; n= 51) was characterized by children who showed the worst performance of mastication, swallowing and breathing functions and whose parents reported the consumption of sweets, cookies, chocolate, but not fresh fruits the day before, in addition to the higher bottle-feeding and pacifier use duration. This cluster also showed higher sweet taste threshold. Cluster 2 ("High orofacial myofunctional functioning"; n= 40) showed lower bottle-feeding and pacifier use duration, higher gustatory sensitivity, greater maxillo-mandibular dimensions, and better orofacial function performance. The variables sex and BMI did not associate to clusters profile. The frequencies of open bite and current sucking habit (pacifier) also differed between clusters. The results showed that an association between form and function of the structures that comprise the stomatognathic system and dietary intake is already present in children with primary dentition.

Parafunctional Oral Habits: Frequency and Association with Malocclusion Traits in Adolescents

OBJECTIVE: To determine the frequency of parafunctional oral habits and their association with types of malocclusions in all three planes among the adolescents. METHODOLOGY: This cross-sectional study involved 610 students studying in 8 different schools of Raiwind, Lahore. Ethical approval for the study was obtained from Sharif Medical and Dental College, Lahore. Data was collected by the primary researcher and recorded in predesigned proforma. Each student was inspected while seated in an upright position in natural day light, using disposable wooden blades to retract the cheek to record posterior dental relationships and to retract lips to record anterior dental relationships. Data was scrutinized using SPSS and chi-square test was used to find the statistical significance of the association between various parafunctional oral habits and types of malocclusions. RESULTS: The frequency of parafunctional oral habits was 57.3% among 610 adolescent students, being more prevalent in females (72.9%) than males (52.3%). The most common oral parafunctional habit was bruxism (18.0%) and least frequent was thumb sucking (8.4%). Association between oral parafunctional habits and malocclusion in all three planes was found to be significant (p=0.0). CONCLUSION: The parafunctional oral habits such as bruxism, tongue thrusting, nail biting, mouth breathing and thumb sucking are very commonly found among adolescents in the same descending order. Most common malocclusions found to be associated with parafunctional oral habits are exaggerated over-jet, open bite and deep bite. Parafunctional oral habits have a strong influence on developing malocclusion traits in all three dimensions. KEYWORDS: Parafunctional oral habits, malocclusion, thumb sucking, tongue thrusting, mouth breathing, bruxism, nail biting.

Treatment of Severe Anterior Open-bite Accompany with Impacted Canine: A Case Report

Introduction: The anterior open bite is a multifactorial malocclusion and a challenge between orthodontists. Based on the origin, divided in two types as dental and skeletal, and appear in the anterior or posterior segments, (unilateral or bilateral). Dental open-bite in the most of patients have environmental etiologic factor such as oral habits, tongue trust, mouth breathing, large tongue. In skeletal type, excessive vertical growth of the maxilla is etiologic factor and accompany with downward-backward rotation of the mandible.Case Report: The case was a 27 years woman with an anterior open bite and unilateral impacted upper canine and congenital missing of lower 2nd premolar in the left side and retained 2nd lower deciduous molar and upper canine in the left side. She consulted for orthodontic treatment in Tehran Dental School of Shahid Beheshti University of Medical Sciences in October of 2017.The Orthodontic treatment was down with MBT slot 22 system (USA. Orthoorganizer, inc) for apply extrusive force on impacted upper canine in left side with auxiliary 014 ss, segmented arch wire. loop arch wire technique with 16 × 22 ss rectangular continuous arch wire was used for space closing in extraction site and correction overbite. The extracted teeth were right lower 2nd premolar and left 2nd deciduous molar and 1st premolars in upper arch. As recommended advancement genioplasty for correction chin deficiency the patient refused it. Conclusion: In this technique we used Orthodontic treatment alone instead of Orthognathic surgery for open bite correction.

Analysis of orocraniofacial changes in children with congenital zika syndrome: a case series

This article aims to describe orocraniofacial alterations in children with Congenital Zika Syndrome. A descriptive case series study was carried out with 20 children with the syndrome, attended at a rehabilitation center in the city of Recife, Pernambuco, Brazil. The presence of oral, craniofacial and neurological alterations, oral health condition and gestational period were evaluated. Data were obtained from medical records and interviews with the children's mothers, followed by a physical examination. Among the main alterations found are microcephaly, craniofacial disproportion, epicanthal folds, bruxism, anterior open bite, ankyloglossia, tongue interposition and delay in teeth eruption. The child may have difficulty reporting any discomfort due to neurological impairment, therefore, these findings reinforce the importance of preventive dental consultations and the performance of the dental surgeon in the elaboration of protocols and guidelines aimed at providing a better quality of life for these patients.