Open Bite Cases Research Articles

Does Invisalign Outperform Fixed Appliance in Treating Vertical Discrepancies?

Aligners became popular among adult patients for their superior aesthetics and comfort in comparison to conventional fixedappliances. It has undergone numerous enhancements over time, allowing it to address more complex malocclusions. Many researchers argued that managing vertical discrepancies is more challenging than addressing anteroposterior issues. This complexity arose from the mechanical requirements for treatment and the required mechanics to prevent relapse. Studies assessing the treatment outcome of anterior open bite closure using clear aligners have yielded conflicting results regarding the mechanisms of bite closure. Proposed mechanisms included extrusion of upper or lower incisors, lingual tipping of upper or lower incisors, intrusion of upper or lower molars, counterclockwise rotation of the mandible, or various combinations of these mechanisms. The research highlighted the biomechanical challenges associated with using aligners for the treatment of deep bites as mandibular incisor intrusion and leveling the curve of Spee remain among the least predictable movements. Given the widespread use of aligners, it is imperative to rigorously assess the effectiveness of clear aligners in achieving overbite correction to ensure they deliver the desired outcome. This review aimed to assess the performance of Invisalign in the management of vertical discrepancies. It sought to identify the dentoskeletal effects of clear aligners in addressing deep bite and anterior open bite cases, understand the mechanisms behind overbite correction, and provide a comprehensive overview of the existing research on this topic.

Effect of Different Mini Implant Assisted Rapid Palatal Expansion (MARPE) Designs on Maxillary Protraction in Skeletal Class III malocclusion: An FEM Study.

Four different designs of mini-implant-assisted rapid palatal expansion (MARPE) and protraction in nasomaxillary complex and mid-palatal sutures in late adolescent skeletal Class III malocclusion were compared using a three-dimensional finite element analysis. A finite element model of skull and related sutures was constructed using the computed tomography scan of a 16-year-old female patient with skeletal Class III and ANB of -2°. Four appliance designs: Type I: MARPE with palatal force, Type II: MARPE with buccal force, Type III: Hybrid hyrax with palatal force, and Type IV: Hybrid hyrax with buccal force. Protraction vectors were and analyzed using Ansys software (ANSYS 2021 R2). The displacement pattern of the nasomaxillary structures and the stress distribution in the sutures were examined in all four appliance designs. All the appliance designs resulted in a forward movement of the maxilla, while Type I and III, which used palatal protraction force, caused the greatest forward displacement. In Type I, II, and III, along with forward movement, a clockwise rotation of maxilla was observed, while in Type IV, an anticlockwise rotation of maxilla was observed. Type I, II, and III resulted in higher stress distribution around the superior structures, while Type IV resulted in less stress distribution around the superior structures of maxilla. The forward displacement was enhanced when palatal plates were used to protract the maxilla. The effective appliance design for skeletal class III with open bite case was Type I, II, and III and Type IV for deep bite cases.

Clinical case of treatment of anterior open bite malocclusion in a pediatric patient using a tongue trap

Anterior open bite is a complex and multifactorial malocclusion that affects both dental function and aesthetics. The objective of the study was to present a clinical case of anterior open bite (AOB) treatment in a pediatric patient using a lingual trap. A case study was conducted on a 7-year-old girl with AOB, employing a removable orthopedic appliance. The treatment consisted of using a lingual trap to correct the open bite and promote proper mandibular growth, with monthly check-ups and a total duration of 12 months. The results showed a significant improvement in occlusion and dental alignment, as well as in the facial profile. It is concluded that the lingual trap is an effective tool in the treatment of anterior open bite in pediatric patients, highlighting the importance of an integral and personalized approach to achieve successful results

Blanket or tailored prescription of retainers in orthodontics: a questionnaire-based study.

To explore retainer protocols and how they are influenced by orthodontic presentation and the nature of occlusal correction. A prepiloted 45-item online questionnaire targeting orthodontists was developed. The questionnaire covered clinical preferences in terms of retainer type, fabrication, and follow-up during retention; the clinical indications for adjunctive surgical procedures; and the use of active designs to mitigate relapse in specific malocclusions. A total of 206 responses were obtained. The majority of the respondents prescribed maxillary removable and mandibular fixed retainers, with almost half (49.1%) reviewing patients for more than 1 year primarily in person (95.1%). The majority prescribed vacuum-formed (69.6%) 1-mm-thick (44.3%) retainers. Only 37.3% were aware of the type of material used, with polyethylene terephthalate glycol copolymer, followed by polypropylene, being the most common. Hawley retainers were preferred following nonsurgical maxillary expansion and with suboptimal interdigitation. A preference for clear retainers and/or fixed retainers was found in open-bite cases and deep-bite cases. Supracrestal fiberotomy was prescribed commonly (61.1%) for rotations greater than 90°. No retainer was rarely prescribed except after the correction of an anterior crossbite. Blanket prescription of orthodontic retention is common, with limited awareness of clear plastic retainer materials. Future trials evaluating the effectiveness of approaches for retainer prescription based on the presenting malocclusion would be timely.

Stability of anterior open bite cases treated with upper and lower extrusion arches in adults: a follow-up study.

To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults. 23 patients with AOB were treated with extrusion arches and evaluated for dentoskeletal changes using lateral cephalometric radiographs before treatment (T0), after treatment (T1), and 12 months post-treatment (T2). Patients received bondable tongue spurs and vacuum-formed retainers as post-treatment retention/stability measures for 12 months. Post-treatment stability was further assessed qualitatively by the Photographic Openbite Severity Index. All the cases showed positive overlap between the anterior teeth at the end of orthodontic treatment, and 20 of 23 treated patients attended the recall visit after 12 months. A total of 85% of the cases maintained positive overlap at least 1 year post-treatment, 10% showed edge-to-edge bite, and only 5% showed no overbite. Treatment of AOB in adults with extrusion arches proved to be stable 1 year post-treatment. Changes in the overbite after 1 year of follow-up were not significant.

Evaluation of condyle-fossa relationships in skeletal Class I malocclusion with variable degrees of deep overbite and open bite

ABSTRACT Objective To compare the temporomandibular joint (TMJ) position and shape between skeletal Class I subjects with different degrees of deep overbite or open bite and unaffected peers. Methods Cone beam computed tomography (CBCT) images of 90 participants, equally divided into deep bite, open bite, and control groups (DBG, OBG, and CG, respectively), were analyzed. The DBG and OBG were further subdivided into three subgroups based on the severity. Linear and angular measurements were used to determine the positional and morphological characteristics of the TMJ. Results DBG showed significantly larger superior joint space, anterior inclination of the condyle, and articular eminence inclination than CG and OBG. The severity of deep bite and open bite significantly influenced the TMJ position and morphology. Conclusion In severe deep overbite and open bite cases, there were considerable alterations in TMJ components, most likely as a result of functional demands.

Changes in the occlusal function of orthognathic patients with vertical malformations after combined orthodontic surgical therapy: a prospective clinical study

The aim of this study was to assess the changes in occlusal patterns during combined surgical and orthodontic therapy in patients with vertical jaw malformations. Twenty-six orthognathic patients (18 female, eight male; median age 25 years, interquartile range 11.5 years) and 10 control patients (five female, five male; median age 29.8 years, interquartile range 13.5 years) recruited from neutral configured patients attending the Department of Orthodontics, were investigated. Based on cephalometry, the patients were grouped into vertical skeletal configurations of either open, deep, or natural bite cases. Registrations of the occlusal contacts were taken using a digital occlusal sensor immediately before surgery and at 9 months after the surgical intervention. Before the intervention, open and deep bite patients showed significantly less efficient occlusal patterns than the untreated controls regarding total tooth contact (P < 0.001), time of occlusion (P = 0.002), occlusal asymmetry (P = 0.001), anterior tooth contact (P < 0.001), and posterior tooth contact (P < 0.001). After surgery, the parameters in the deep bite patients were similar to those in the controls; however, in open bite patients, total tooth contact (P = 0.003), occlusal asymmetry (P = 0.011), and posterior tooth contact (P = 0.035) differed significantly. In conclusion, combined orthodontic and surgical correction of vertical malocclusions was found to improve occlusal function in patients with deep bite to the level of controls.

Assessment of the Diagnostic Skills of General Dentists in Different Types of Orthodontic Malocclusions.

One of the biggest problems in publicly funded dental clinics is the patient waiting list. The appropriate referral plays a key role in avoiding an increase in the number of patients on this waiting list. This study aimed to assess general dentists' diagnostic skills and approaches for different malocclusions. A questionnaire was prepared using photos of 8 patients previously treated for different malocclusions. One hundred twenty general dentists (83 female, mean age: 24 ± 1.18 years; 37 male, mean age: 24 ± 1.95 years) participated in the survey and were asked to decide whether the patient needed orthodontic treatment or orthognathic surgery, and to provide the reason for surgery (irregular teeth, or both unesthetic profile and irregular teeth), and the cause of the unesthetic profile (mandibular protrusion, mandibular retrusion, maxillary protrusion, maxillary retrusion). The answers suggesting the need for orthodontic treatment were significantly higher for all malocclusions except for the Class II camouflage case. Of the Class III cases, the general dentists chose orthognathic surgery for both surgery and facemask cases (93.1%, 66.4% respectively). For the severe open bite case, orthognathic surgery was chosen with a ratio of 81.2%, and orthognathic surgery was decided as not necessary for the mild open bite case (74.8%). Among the surgery cases, mandibular retrusion for the Class II case (94.6%), mandibular protrusion for Class III case (95.4%), and maxillary retrusion for the severe open bite case (44.6%) were the maximum reported reasons. The distinction between camouflage and surgical treatment was better made by dentists in Class II and open bite cases than in Class III cases.

Treatment Option Criteria for Open Bite with Receiver Operating Characteristic Analysis—A Retrospective Study

Temporary anchorage devices (TADs) allow molar intrusion as an additional treatment option to conventional treatment for open bite cases. We investigated the treatment option criteria for open bite treatment. A total of 33 patients with skeletal Class I to Class II open bite who had stable occlusion one year after treatment were enrolled in the study, including 15 patients who had undergone surgical orthodontic treatment, 8 patients who had undergone treatment with molar intrusion, and 10 patients who had undergone treatment with anterior teeth extrusion. Pre-treatment cephalometric analysis of these patients was used for comparison. Furthermore, receiver operating characteristic (ROC) curve analysis was employed to examine the measurement parameters that would be valid as treatment criteria. In the results, FMA showed that patients treated with molar intrusion had a moderately high angle, while those treated with surgical orthodontic treatment had a severe high angle. The area under the curve (AUC) of the ROC curve indicated that FMA is the most appropriate parameter for treatment option criteria. In addition, the cutoff value indicated that the borderline between molar intrusion and surgical orthodontic treatment was 37.5° for FMA. In this study, we suggested criteria for the treatment of open bite with molar intrusion.

Evaluation of the open-bite Bionator versus the removable posterior bite plane with a tongue crib in the early treatment of skeletal anterior open bite: A randomized controlled trial

Several treatment approaches can be found in the literature about early treatment of open bite. However, no studies have addressed the use of a removable posterior bite plane with a tongue crib (RPBP/C), compared with functional appliances, for treating open-bite cases. The objectives of this trial was to compare the effectiveness of the open-bite Bionator (OBB) and the RPBP/C as an early intervention to correct skeletal open-bite cases in children, in terms of limiting excessive vertical growth of the craniofacial skeletal components and normalizing the developement of the anterior dentoalveolar region. Two-arm, parallel-group randomized controlled trial was conducted. Forty patients with a skeletal anterior open bite (age range: 7.5-10.5 years) were treated at the University of xxxx School of Dentistry in xxxx, xxxx. They were distributed randomly into 2 equal groups: the OBB group (20 patients; mean age: 8.8 ± 1.5 years) and the RPBP/C group (20 patients; mean age: 8.6 ± 1.1 years). Randomization was based on a computer-generated sequence of random numbers. Primary outcome measures were the skeletal and dentoalveolar variables, whereas the secondary outcome measures were the soft-tissue parameters assessed on standardized lateral cephalograms collected before and after 12 months of treatment. Mann-Whitney U tests were used to detect significant differences between the 2 groups. Both the OBB and the RPBP/C appliances induced favorable dental effects. A statistically significant difference was found between the 2 groups in the overbite (P=0.003). Open bite in the OBB group showed a mean closure of 4.91 mm (SD 0.4 mm), and a mean closure of 3.43 mm (SD 0.3 mm) was observed in the RPBP/C group. Dentoalveolar changes at the anterior region were evident, with statistically significant extrusion, and lingual tipping of the maxillary and mandibular incisors (P ≤ 0.05). The results showed no significant differences in the skeletal changes between the 2 groups. The OBB and the upper posterior bite plane with crib were both effective in the early treatment of the skeletal anterior open bite. However, closure of the anterior open bite was mainly due to the dentoalveolar changes at the anterior region of the dental arches.

Molar Intrusion using TADs in the Management of an Anterior Open Bite: A Case Report

The prevalence of an anterior open bite ranges in the literature from 1.5% to 11%, with great racial variance. Stable non-surgical treatment of an anterior open bite is notoriously unpredictable, with a high risk of relapse and an uncertainty of true skeletal change. Temporary anchorage devices (TADs) are increasingly used to enhance and simplify orthodontic biomechanics, enabling clinicians to push the boundaries of orthodontic treatment. In anterior open bite cases, TADs may be used predictably for molar intrusion and improvement of the overbite. We describe a 16-year-old male with a Class I incisal relationship on a skeletal I base and increased vertical proportions, complicated by a 4-mm anterior open bite secondary to a previous digit sucking habit. Treatment involved fixed orthodontic appliances on an extraction basis, and molar intrusion using TADs. TADs provide a safe and effective alternative to reducing an anterior bite in a patient whose growth is complete. CPD/Clinical Relevance: Understanding the options for the treatment of an anterior open bite and the limits of orthodontic camouflage will help clinicians provide their patients with the necessary information with which to make informed decisions.

Efetividade do tratamento ortodôntico interceptativo com aparelho removível em crianças com mordida cruzada e mordida aberta na fase de dentadura mista

A interceptação de maloclusões em estágios iniciais contribui para um crescimento equilibrado das bases ósseas. Dentre as maloclusões que devem ser corrigidas antecipadamente, destacam-se as mordidas cruzadas e mordidas abertas, nessa ordem de prioridade. Uma gama de possibilidades terapêuticas existe descritas na literatura, entre essas, o uso de aparelho removível com expansor e grade lingual. Entretanto, poucas evidências validam essa forma de tratamento, baseado nesse pressuposto o objetivo do presente estudo foi avaliar a efetividade do aparelho removível com expansor e grade lingual para correção da mordida cruzada posterior associado a mordida aberta anterior. Analisou-se as documentações ortodônticas de 148 crianças na faixa etária de 5 a 12 anos de idade que receberam tratamento entre os anos de 2009 e 2018. A efetividade ou não do tratamento foi verificada ao analisar fotografias e modelos de estudo em duas etapas de tratamento: inicial e final. Após realização de testes Shapiro-Wilk, as frequências foram comparadas pelo teste qui-quadrado e as variáveis calculadas a partir do teste Kruskal-Wallis. Foi constatado que 74% dos casos de mordida cruzada e 91,7 % dos casos de mordida aberta foram corrigidos. Dessa forma pode-se concluir que a correção da mordida aberta e mordida cruzada foi conseguida com o uso desses dispositivos.

Relationship between back posture and early orthodontic treatment in children

BackgroundThe purpose of this study was to analyze the relationship between body posture and sagittal dental overjet in children before and after early orthodontic treatment with removable functional orthodontic appliances.MethodsAngle Class II patients (mean age 8.2 ± 1.2 years; 29 males and 25 females) with a distinctly enlarged overjet (> 9 mm) were retrospectively examined regarding body posture parameters before and after early orthodontic treatment. In addition, changes in overjet were investigated with the aid of plaster models. Forms of transverse dysgnathism (crossbite, lateral malocclusions) and open bite cases were excluded. Body posture parameters kyphosis, lordosis, surface rotation, pelvic tilt, pelvic torsion and trunk imbalance were analyzed by means of rasterstereographical photogrammetry to determine, if the orthodontic overjet correction is associated with specific changes in posture patterns.ResultsIn nearly all patients an overjet correction and an improvement regarding all body posture and back parameters could be noted after early orthodontic treatment. Overjet reduction (− 3.9 mm ± 2.1 mm) and pelvic torsion (− 1.28° ± 0,44°) were significantly (p < 0.05) and moderately correlated (R = 0.338) with no significant associations found for the other posture and back parameters (p > 0.05).ConclusionOverjet reduction during early orthodontic treatment may be associated with a detectable effect on pelvic torsion.

Endogenous Tongue Thrust – Myth?

Anterior open bite cases are very challenging to manage due to the high relapse potential associated with this feature of malocclusion. It is helpful if the aetiology is established before embarking on treatment to ensure that the appropriate treatment modalities are carried out. Determining whether the aetiology of an anterior open bite is caused by an ‘endogenous tongue thrust’ is extremely difficult. In particular, differentiating between an adaptive and endogenous tongue thrust can be extremely challenging. The case study presented explores the clinical considerations when diagnosing and treating anterior open bites. CPD/Clinical Relevance: This report raises the question: is it possible to diagnose an endogenous tongue thrust?

Use of a modified vertical holding appliance for open bite interceptive treatment in growing patients.

The aim of this paper is to illustrate the use of a modified vertical holding appliance (G-VHA) to obtain the vertical control of maxillary molars and tongue stimulation in order to achieve a transverse activation in growing patients with dental open bite without the patient's compliance. The G-VHA is a modified trans-palatal bar with a resin pad covering the Omega central loop and two adjunctive lateral loops to ensure the bar flexibility. The G-VHA is designed to direct the force of the tongue against the upper molars to generate intrusion and at the same time to stimulate and re-educate the tongue. Two cases of dental open bite in growing patients are illustrated. Both patients were successfully treated, and the open bite was fully corrected thanks to molar intrusion, following counterclockwise rotation of the mandible and tongue correction. Finishing of alignment was performed in phase II of the treatment with conventional appliances. The G-VHA proved to be effective in controlling the vertical position of maxillary molars promoting the counter-clockwise rotation of the mandible and stimulating a different tongue posture.

PREVALENCE AND STRUCTURE OF DENTOALVEOLAR ANOMALIES AMONG STUDENTS OF DONETSK REGION

Harmonious facial aesthetics, proper bite, straight teeth are an integral part of individual psychological well-being and a modern person’s professional success. According to scientific studies, orthodontic pathology occupies third place in terms of incidence among dental diseases after dental caries and periodontal diseases. Being man-made polluted, the Donetsk region also has a high prevalence of dentoalveolar anomalies. In 7-15 year old children, the incidence rate is 68-90%.&#x0D; The aim of the study is to research the prevalence and structure of dentoalveolar anomalies among students of a medical university in the Donetsk region.&#x0D; Materials and methods. To fulfill the purpose of the study we analyzed the orthodontic status of 300 Donetsk National Medical University students. Examinations of students were performed according to the generally accepted method in dentistry. The material of the clinical trial was subjected to variational-statistical analysis in accordance with the purpose of the study.&#x0D; Results. The analysis of the study data showed that there were abnormalities in the attachment of the oral soft tissues, namely 56,0% (168/300) of those examined had a short bridle of the tongue, 20,0% (60/300) of students – a short bridle of the upper lip, 5,3% (16/300) patients – a short frenulum of the lower lip and 17,3% (52/300) of those examined – a shallow vestibule of the mouth. The data on the orthodontic status of the examined patients showed that the prevalence of dental anomalies was 98,7% (296/300). 64% (192/300) of examined subjects had anomalies of occlusion in combination with anomalies of individual teeth. Anomalies of individual teeth without occlusion pathology were diagnosed in 34,7% (104/300) of patients. 1,3% (4/300) of students have been found to be orthodontically healthy. Moreover, the case history of those examined shows that 30,7% (92/300) of students underwent orthodontic treatment in the past, which was not always successful. The external examination revealed facial signs of dentoalveolar anomalies in 50,0% (148/296) of students, which indicates the gnathic nature of orthodontic pathology. Deep bite (54,2%) and deep occlusion in combination with distal occlusion (25,0%) were significant. Class 2 pathology was detected in 10,4% (20/192) of individuals. The examination did not reveal any cases of open bite in the subjects. The prevalence of crossbite and mesial occlusion was low and amounted to 8,3% (16/192) and 2,1% (4/192) of cases, respectively. Teeth rotation was prevalent (71,6%; 212/296) among 296 students who had anomalies of individual teeth and dentition (isolated or combined with an occlusion anomaly). The results of the study indicate that 56,6% of those examined (120/212) had lower teeth rotation, 26,4% of subjects (56/212) presented with the combination of this pathology in both jaws, and tortoanomaly of upper teeth was found in 17,0% (36/212) of cases. Crowding of the frontal mandible segment was also a common pathology (58,1%;172/296), the first degree of this pathology’s severity being prevalent (79,0%; 136/172). Examination of students showed that 51,4% of subjects had a vestibular position of individual teeth (152/296). Oral position of teeth and crowding of the frontal upper segment were less common and were observed in 43,2% (128/296) and 29,7% (88/296) cases, respectively. Among the examined students diastemata and tremata were diagnosed in 13,5% (40/296) and 25,7% (76/296) cases, respectively. It should be noted that this pathology predominantly affected the upper jaw: diastema occured in 90% (36/40), and tremata in 57,9% (44/76) of cases. The examination revealed an abnormal inclination of the students’ front teeth. The overall prevalence of protrusion of incisors was 13,5% (40/296), maxillary protrusion of teeth being most prevalent (90%; 36/40). The incidence of incisor retrusion was 10,8% (32/296). Also, this pathology predominated in the upper jaw (87,5%; 28/32). The study of dentition disorders revealed the prevalence of transversely and sagittally oriented changes in the shape of dental arches. The results revealed that the shortening of the dentition was the most common dentition deformation, being detected in 66,9% (198/296) of cases. The narrowing of the dentition was found in 51,0% of subjects (151/296).&#x0D; Conclusions. Such studies allow to improve the prevention principles of dentoalveolar anomalies and to organize the timely provision of specialized medical care.

Effect of piezocision on molar intrusion in open-bite treatment using a modified MEAW technique.

The aim of this retrospective study was to investigate whether a piezocision technique influences molar intrusion in open-bite cases. In all, 30patients with open-bite malocclusion were assigned to one of two groups: the piezocision groupcomprised 15patients who were treated using curved arches and anterior elastics with the simultaneous combination of piezocision which was performed interdentally in the upper posterior region, while the control group comprised 15patients who were treated with the same treatment mechanics without piezocision. In both groups, after leveling and aligning, upper 0.017 × 0.025 accentuated curve and lower 0.017 × 0.025 reversed curve of Spee NiTi archwires were placed. Anterior vertical elastics were applied between laterals and the canines on both sides. The effects of treatments were investigated on cone-beam computed tomography images acquired before use of elastics and after correction of open-bite. Open-bite closure was achieved in 2.85 ± 0.85 and 4.1 ± 1.58months in the piezocision and control groups, respectively, while total treatment lasted 1.4 ± 0.42 and 1.7 ± 0.43years, respectively. Extrusion of lower posterior teeth (p < 0.05) was observed together with extrusion of incisors and canines (p < 0.001) in the piezocision group, while only incisors and canines were extruded in the control group (p < 0.001). There were no significant differences between the groups (p > 0.05) except significant lower incisor extrusion (p < 0.05) and counter-clockwise rotation of the lower occlusal plane in the piezocision group (p < 0.001). The duration of open-bite correction was significantly shorter in the piezocision group. No molar intrusion was observed in either group. Open bite correction was achieved mainly by extrusion and retrusion of the incisors while maintaining upper molar positions.

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.

Efficacy of Clear Aligners in Correcting Anterior Open Bite- A Systematic Review

Objective:The aim was to systematically search the literature and assess the available evidence regardingtheclinical effectiveness of clear aligners in correcting anterior open bite.Materials and Methods:PubMed, PubMed Central, MEDLINE, Embase, National Library of Medicine,Cochrane Library, Web of Knowledge, and LILACS were searched electronically to identify all peerreviewed articles till date potentially relevant to the review.The reference lists of all eligible articles wereexamined for additional studies. Additional manual search was also conducted in many orthodontic journalsof interest, and unpublished articles were also searched for. To rate the methodological quality of the selectedarticles, a grading system described by the Swedish Council on Technology Assessment in Health Care wasused.Results:Ten relevant articles were selected to be included in this systematic review. According to the SBUtool, among the selected studies, the methodological quality was moderate for four studies and limited forthe others. Thus, conclusions with a limited level of evidence could be arrived at from the review process.The most recurrent sources of bias were related to the study design, lack of blinding procedure, the samplesize, and the lack of control group. However, there was substantial consistency among studies that clearaligner therapy is a viable option to correct anterior open-bite.Conclusion:No definite conclusion could be derived due to the heterogeneity of the studies. Due to thelimitations of this study, further clinical and experimental research is needed to statistically assess long-termstability of occlusion and skeletal relationships in treated open-bite cases.

Atypical swallowing behind an unusual case report of anterior open bite and an anterior midline Diastema

Atypical swallowing is a my functional problem consisting of an altered tongue position during the act of swallowing, connection with the presence of malocclusions such as anterior open bite made it a topic of strong interest and discussion in science.Anterior open bite is considered a malocclusion that still defies correction, especially in terms of stability, midline Diastema create an unpleasant appearance for individuals, sometimes it may lead to phonetic problems, particularly in cases with wide space. This article describes a clinical rare case of a severe anterior open bite and an unusual midline Diastema which resulted from an atypical swallowing and shows the importance to set up an early my functional rehabilitation procedure to correct the oral habit and to prevent such malocclusion with consequences on aesthetics and self-confidence.