Posterior Bite Blocks Research Articles

An innovative approach for treatment of anterior open bite in Class II Division 1 patient with VF appliance (Zygomatic Implant and Spur Assisted) - A case report

Controlling anchorage is one of the foremost necessary aspects of treatment. Moderate anchorage is comparatively simple to manage with the use of some intraoral appliances and biomechanical procedures. On the opposite hand, cases that need the most anchorage need extraoral support to strengthen the anchorage. In some instances, 100 percent anchorage has got to be maintained, such an anchorage may be termed as absolute anchorage. It's tough and not possible to get absolute anchorage by using typical ways like extraoral force application. In this case report, we describe the treatment of Open bite by using the support of Zygomatic plates and Spurs anteriorly placed with the combination of posterior bite blocks. A 20-year-old female reported to our department of orthodontics with the chief complaint of anteriorly placed upper front teeth. There was no relevant medical history; she was having tongue thrusting habit, acute nasolabial angle and incompetent lips. Overjet of 12mm and anterior skeletal open bite from canine to canine of 5mm was present associated with anterior tongue thrusting habit, and constricted upper arch. The molar relation was end-on on the right side and class II on left side. Canine relation is end-on, on both the side. Growth pattern is vertical. Upper arch is well aligned with constriction in premolar region; lower arch has crowding of 6 mm. The treatment plan was selected as alignment of the teeth with fixed mechanotherapy and impaction of the maxillary posteriors using zygomatic anchorage with posterior bite block and spurs soldered to the anterior part of the appliance. The sutures were removed after 7 days, the appliance was inserted into the patient’s mouth and secured with a power chain to the hooks of the appliance and the hook of zygomatic implant, 400gms of force was applied on both the sides.

An innovative approach for treatment of anterior open bite in Class II division 1 patient with zygomatic implant and spur assisted appliance - A case report

Controlling anchorage is one of the foremost necessary aspects of treatment. Moderate anchorage is comparatively simple to manage with the use of some intraoral appliances and biomechanical procedures. On the opposite hand, cases that need the most anchorage need extraoral support to strengthen the anchorage. In some instances, 100 percent anchorage has got to be maintained, such an anchorage may be termed as absolute anchorage. It's tough and not possible to get absolute anchorage by using typical ways like extraoral force application. In this case report, we describe the treatment of Open bite by using the support of Zygomatic plates and Spurs anteriorly placed with the combination of posterior bite blocks.A 20-year-old female reported to our department of orthodontics with the chief complaint of anteriorly placed upper front teeth. There was no relevant medical history; she was having tongue thrusting habit, acute nasolabial angle and incompetent lips. Overjet of 12mm and anterior skeletal open bite from canine to canine of 5mm was present associated with anterior tongue thrusting habit, and constricted upper arch. The molar relation was end-on on the right side and class II on left side. Canine relation is end-on, on both the side. Growth pattern is vertical. Upper arch is well aligned with constriction in premolar region; lower arch has crowding of 6 mm. The treatment plan was selected as alignment of the teeth with fixed mechanotherapy and impaction of the maxillary posteriors using zygomatic anchorage with posterior bite block and spurs soldered to the anterior part of the appliance. The sutures were removed after 7 days, the appliance was into the patient’s mouth and secured with a power chain to the hooks of the appliance and the hook of zygomatic implant, 400gms of force was applied on both the sides.

Effect of rapid maxillary expander with posterior bite blocks in hyperdivergent patients with adenoid hypertrophy- A cephalometric study

To analyze the effect of Rapid Maxillary Expansion (RME) with posterior bite blocks on craniofacial structures in hyperdivergent patients with adenoid hypertrophy and to compare them with control group. 32 patients of adenoid hypertrophy (mean age 11.6 yrs, range 8-12 years) with a transverse discrepancy were selected and divided into two groups in a random way - Group A: (n=16) hyrax RME with posterior bite block group, Group B: (n=16) control group. Group A- Lateral and Posteroanterior cephalograms were recorded pretreatment (T0), postexpansion (T1), and after 9 months retention (T2). Group B- Lateral and Posteroanterior cephalograms were recorded pretreatment (T0), and after 9 months (T2) concurrent with Group A. Cephalometric measurements in sagittal, vertical and transverse dimensions were taken and comparison was made using Paired and Unpaired t-test with p < 0.05 as statistically significant. Group A underwent insignificant increase in SN-MP angle whereas it increased significantly in Group B. The lower facial height and jarabak’s ratio decreased significantly. All transverse parameters increased significantly with maximum increase in intermolar width when compared with Group B. Significant increase in the transverse dimensions of mid face occurs with RME thus increasing the upper airway patency and effective control of the vertical growth pattern, typical of adenoid hypertrophy, was seen in the treatment group when compared with the control group.

Use of a Posterior Bite Block Modified with TPA and Palatal Crib for Treating Open Bite in Growing Individual: A Case Report

Background: The aim of this paper is to illustrate the use of a Posterior bite block modified with TPA and Palatal crib to obtain the vertical control of maxillary molars, restrict tongue pressure as well as Intruding posterior molars thereby auto rotating mandible. Case Report: Use of posterior bite block modified with TPA and Palatal crib for correcting Anterior Open bite in growing individual is illustrated. Patient was successfully treated, and the open bite was fully corrected thanks to molar intrusion, following counter clockwise rotation of the mandible and tongue correction. Finishing of alignment was performed in phase II of the treatment with conventional appliances. Conclusion: Posterior bite block modified with TPA and Palatal crib 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.

Use of a Posterior Bite Block Modified with TPA and Palatal Crib for Treating Openbite in Growing Individual: A Case Report

Use of a Posterior Bite Block Modified with TPA and Palatal Crib for Treating Openbite in Growing Individual: A Case Report

Management of Anterior Open Bite and Skeletal Class II Hyperdivergent Patient with Clear Aligner Therapy

In orthodontics, patients with hyperdivergent facial types or problems in the vertical dimension are often challenging to treat with predictable treatment results. Conventionally along with fixed appliances, a headgear, posterior bite block, extraction, temporary anchorage devices, or orthognathic surgery are preferable approaches to treat such patients. This case report illustrates a non-extraction, non-surgical orthodontic treatment of 5 mm anterior open bite in a non-growing adult patient, utilizing clear aligner therapy.

Evaluation of the acceleration, skeletal and dentoalveolar effects of low-level laser therapy combined with fixed posterior bite blocks in children with skeletal anterior open bite: A three-arm randomised controlled trial

To evaluate the effectiveness of the low-level laser therapy (LLLT) in accelerating the early treatment of the skeletal anterior open bite (AOB) and to evaluate the associated skeletal and dentoalveolar changes. A three-arm, parallel-group, randomized controlled trial was conducted on 42 patients aged 8-10 years with skeletal AOB. Patients were randomly allocated to three groups: the fixed posterior bite block+low-level laser therapy (FPBB+LLLT) group; the fixed posterior bite block (FPBB) group; and the untreated control group (UCG) in a 1:1:1 allocation ratio. The LLLT dose in the FPBB+LLLT group was applied using 808-nm wavelength Ga-Al-As semiconductor laser device with the energy of 4-joules/point and irradiation time of 16 seconds/point. LLLT was applied in the first visit; then, it was applied on day 3, 7 and 14 of the first month. Afterwards, it was applied every 15 days until the end of the treatment. Lateral cephalometric images were taken at the beginning of the treatment (T0) and at the end of the active phase (T1). The primary outcome measures were the overall time needed to correct the AOB and the skeletal and dentoalveolar changes. The correction of the AOB required significantly less mean time in the FPBB+LLLT group compared to the FPBB group (x̅=7.07, x̅=9.42 months, respectively; P=0.001). The mean upper first molar intrusion in the FPBB+LLLT group was 1.21mm and significantly greater than that of the FPBB group (0.82mm; P=0.018). However, there was a slight mean extrusion of the upper first molar in the UCG (0.32mm). The overall time needed to correct the AOB was shorter in the FPBB+LLLT group. The LLLT appeared to be effective in accelerating orthodontic tooth movement. FPBB alone or LLLT were effective in the early treatment of anterior open bite (AOB). The two interventional groups produced similar dentoalveolar and skeletal changes; most of which were dentoalveolar in the correction of the anterior open bite.

A New Posterior Semi-Fixed Temporary Bite Raising Appliance

In clinical scenarios like anterior cross bite and Angle’s Class II division 2 malocclusion, it is often required to raise the bite temporarily for an effective unobstructed tooth movement of maxillary/mandibular incisors. For relieving the occlusion, numerous removable acrylic plates with bite blocks, glass ionomer splints or fixed bite blocks are commonly used. But each of these are having certain disadvantages. This technique describes semi-fixed posterior acrylic bite blocks which are fixed using “T” shaped spring to the vertically oriented lingual sheaths welded on molar bands both buccally and lingually for added retention. This technique has been found to be reliable and convenient, especially since it allows easy insertion and removal by the orthodontist and avoids the loosening of the bite block before patient’s next visit and keeps the bite open as desired.

Long-term evaluation of rapid maxillary expansion and bite-block therapy in open bite growing subjects: A controlled clinical study.

To evaluate the long-term effects of rapid maxillary expansion (RME) and posterior bite block (BB) in prepubertal subjects with dentoskeletal open bite. The treatment group (TG) comprised 16 subjects (14 girls, 2 boys) with dentoskeletal open bite with a mean age of 8.1 ± 1.1 years treated with RME and BB. Three consecutive lateral cephalograms were available before treatment (T1), at the end of the active treatment with the RME and BB (T2), and at a follow-up observation at least 4 years after the completion of treatment (T3). The TG was compared with a control group (CG) of 16 subjects (14 girls, 2 boys) matched for sex, age, and vertical skeletal pattern. An independent sample t-test was used to compare the T1 to T3, T1 to T2, and T2 to T3 cephalometric changes between the TG and the CG. In the long term, the TG showed a significantly greater increase in overbite (+1.8 mm), reduced extrusion of maxillary and mandibular molars (-3.3 mm), and, consequently, a significant decrease in facial divergence (-2.8°) when compared with untreated subjects. The RME and BB protocol led to successful and stable recovery of positive overbite in 100% of the patients considered. Correction of open bite was associated with reduced extrusion of maxillary and mandibular molars with a significant improvement in vertical skeletal relationships when compared with the CG.

Mathematical modeling for explanation and prediction of treatment outcome in growing patients with anterior open bite malocclusion treated with rapid molar intruder and posterior bite blocks

PurposeRapid molar intruder (RMI) is a non-compliant treatment modality for correction of anterior open bite (AOB) in growing patients. The aim of this study is to explain the main treatment outcome (increase in overbite) by the other morphological changes after treatment with RMI and posterior bite blocks (PBBs). We also investigated the baseline characteristics that may help predict the treatment outcome. Subjects and methodsFourteen patients (mean age±SD=10.7±1.7year) with AOB malocclusion were treated with RMI springs and PBBs fixed on posterior teeth for 4 months. Patients were assessed before and after treatment using cephalometric radiographs. Multivariable regression model was developed to explain overbite change by the other morphological components. Single regressions of overbite change on baseline variables were conducted to determine best predictor of treatment outcome. ResultsTreatment produced significant increase in overbite. The change in overbite was best explained by the changes in facial axis angle, upper anterior dental heights and upper posterior dental heights. The best predictor for treatment outcome was the facial axis angle before treatment. ConclusionThe correction of AOB by the RMI may be explained by orthopedic and dental changes resulting from growth and treatment. The orthopedic changes consisting of counterclockwise mandibular true rotation is the strongest contributor to overbite increase. Patients with severe vertical growth pattern tend to have greater closure rate of open bite.

The influence of altered functional loading and posterior bite-blocks on the periodontal ligament space and alveolar bone thickness in rats

Objectives: Posterior bite-blocks are resin-based structures elevating the occlusion and creating intrusive force on the posterior teeth. Bite-blocks were applied to the molars of growing rats and a hard and soft diet was used to create altered functional masticatory forces. The aim of the present investigation was to study the effect of this appliance on the periodontal ligament space and alveolar bone thickness when combined with altered masticatory forces.Material and methods: Fifty-two four-week-old rats were divided into two groups, hard and soft diet. Two weeks later, half of them received a bite-block appliance, creating four groups: control hard (CH), control soft (CS), bite-block hard (BH) and bite-block soft (BS). All were sacrificed at age of 10 weeks. Their heads were scanned by micro-CT and periodontal ligament space (PDL) width, cross-sectional alveolar socket surface and alveolar bone thickness were measured. Analysis of variance (ANOVA) was used to compare the groups.Results: The PDL was 9.2% thinner in the CS group (p < 0.001) and 20.7% in the bite-block groups (p < 0.001) compared to the CH group. Within each of the four groups, the mesiodistal PDL space was larger than the palatobuccal. The alveolar bone was thinner by 5.8% (p = 0.018) in the CS group, 10.7% in the BH group (p < 0.001) and 16.7% in the BS group (p < 0.001) compared to the CH group.Conclusions: Young rats wearing posterior bite-blocks have narrower PDL space and thinner alveolar bone compared to controls. When fed a soft diet, the alveolar bone is even thinner but the PDL showed no difference.

Wi-Fi blocks – Wire-fixed acrylic bite blocks: A new technique for making removable posterior bite blocks

Wi-Fi blocks – Wire-fixed acrylic bite blocks: A new technique for making removable posterior bite blocks

Wi-Fi blocks – Wire-fixed acrylic bite blocks: A new technique for making removable posterior bite blocks

Acrylic bite blocks are commonly used to prop open the bite and relieve occlusion. This technique describes WIFI (wire fixed )acrylic bite blocks which are fixed using “T” shape wires and are free of lingual plates.

Early treatment of anterior open bite: Comparison of the vertical and horizontal morphological changes induced by magnetic bite-blocks and adjusted rapid molar intruders.

ObjectiveThis prospective clinical study aims to determine the differences between two treatment modalities for anterior open bite in growing patients. The treatment modalities involved the use of magnetic bite-blocks (MBBs) or rapid molar intruders (RMIs) applied with posterior bite-blocks.MethodsFifteen consecutive patients with a mean age of 11.2 (standard deviation [SD] = 1.6) years and a mean open bite of -3.9 mm were treated with MBBs. Another 15 consecutive patients with a mean age of 10.9 (SD = 1.8) years and a mean open bite of -3.8 mm were treated with RMIs applied on bite-blocks. Cephalometric radiographs were obtained before (T1) and immediately after appliance removal (T2). The treatments lasted four months, during which the appliances were cemented to the teeth. The morphological changes were measured in each group and compared using logistic regression analysis.ResultsThe MBB group exhibited significantly greater decreases in SNA angle, ANB angle, overjet, and maxillary incisor angle (p < 0.05). The MBBs induced greater effects on the maxilla and maxillary dentition. The MBBs restrained maxillary forward growth and retracted the maxillary incisors more effectively than did the RMIs. Consequently, changes in the intermaxillary relationships and overjets were more distinct in the MBB group.ConclusionsThe anteroposterior differences between the appliances suggest that MBBs should be preferred for the treatment of patients with Class II open bites and maxillary incisor protrusions.

A New Method to retain the Posterior Bite Blocks for Anterior Crossbite Correction

A New Method to retain the Posterior Bite Blocks for Anterior Crossbite Correction

Removable or Fixed??? Force is in the Hands of Orthodontist not Appliance

Abstract Objective: To present a new, simple and economical appliance for bringing a palatally impacted canine into the oral cavity. Material and methods-The basic appliance design incorporatesAdams clasps, usually on both first molars, a posterior bite block and bow of 0.8 mm wire with a stainless steel tubing (to increase the strength) with a helix at the open end, to wear an elastic from attachment on the tooth. Results: Treatment resulted in the eruption of left canine till the occlusal level in the oral cavity through the attached mucosa and simultaneous correction of rotated right canine, with coinciding midlines and no mandibular shift. Conclusion: The simple upper removable appliance can be used as an excellent method of treating palatally impacted canines.

A New Method to retain the Posterior Bite Blocks for Anterior Crossbite Correction

Anterior dental crossbite is a common problem in which maxillary anterior teeth are locked behind the mandibular anteriors. Orthodontic treatment of anterior teeth crossbite need unlocking of upper anterior teeth. Several methods are used to raise the bite for anterior teeth crossbite correction. Posterior acrylic bite blocks are commonly used to raise the bite. Here, in this article, a new method is described to retain the posterior bite block for anterior crossbite correction.

Implant-Supported Bite Blocks for Open Bite Correction in Adults

Altering the vertical dimension of the face remains one of the greatest clinical challenges with a multitude of orthodontic, orthopedic and surgical interventions recommended for the correction of associated skeletal, dental and neuromuscular abnormalities. Along with treatment, long-term stability of open bite corrections remains questionable, mainly because of weak musculature. Use of posterior bite blocks has been advocated to stretch the muscles and in turn increases the muscle strength. Muscle stretching also assists in posterior teeth intrusion. In adult patients, implants have been shown to be quite effective for active intrusion. This article highlights an innovative approach which essentially incorporates posterior bite block with active intruding component, i.e. implants. A specific protocol of treatment and retention with this approach is described.

Dentoskeletal effects of functional appliances vs bimaxillary surgery in hyperdivergent Class II patients

To compare treatment outcomes of growing and nongrowing Class II patients characterized by mandibular retrusion and increased vertical dimension. Seventeen patients (mean age 9 years 5 months) were treated with a Bionator fabricated with posterior bite block and high-pull headgear, while 15 patients (mean age 23 years 6 months) received Le Fort I osteotomy for maxillary impaction and mandibular advancement. These groups were compared with 17 nontreated control subjects from the Bolton and Michigan growth studies. Lateral cephalograms taken for the functional group at T1 (initial records), T2 (completion of functional appliance treatment), and T3 (completion of comprehensive treatment) were compared with radiographs taken at T1 (initial records), T2 (immediate post surgery), and T3 (1 year post surgery) for the surgical patients. A null hypothesis of no difference in treatment outcomes between the functional and surgical groups was proposed. A mixed-design analysis of variance was used to compare changes within and between groups. Significance was set at P ≤ .002. In the functional appliance group, the mandible showed a more favorable growth direction and rotation. Both groups had stable results over time and finished treatment with similar cephalometric measurements. Both the functional appliances and orthognathic surgery resulted in similar dentoskeletal treatment changes. The control groups did not self correct either in the anteroposterior or vertical dimensions.

Berlin standard activator in the treatment of growing patients with mandibular deficiency: Case report

Activator is a removable functional appliance used for correcting the skeletal Class II malocclusion in children with the mandibular deficiency. Berlin standard activator modified from Andresen activator has following characters; do not cover the palatal surface for tongue space, relief on lingual surface of mandibular incisors and resin capping 1/3-1/2 of crown height on mandibular incisors for preventing labioversion of mandibular incisors, L-hook between maxillary lateral incisor and canine for anterior high pull headgear, relief on mandibular posterior bite block for differential eruption of posterior teeth. Two cases presented here had a mandibular deficiency and slight maxillary protrusion. First case (an 11-year-old girl) treated with Berlin standard activator and anterior high pull headgear for 13 months followed by fixed orthodontic appliance for another 29 months. Second case (a 12-year-old boy) treated with Berlin standard activator for 6 months followed by fixed appliance for another 24 months. Treatment results showed a significant improvement in sagittal skeletal and occlusal relationship without premolar extraction. Mandibular condyles were concentric in TMJ [ossa, and masticatory muscle activities were normalized after treatment. In the retention period facial harmony and occlusal stability was maintained.