Treatment Of Open Bite Research Articles

Efficacy of Clear Aligner Therapy for the Treatment of Anterior Open Bite in Adults: A Systematic Review and Meta-Analysis.

The objective of the present systematic review and meta-analysis was to assess the effectiveness of clear aligner therapy (CAT) for the treatment of anterior open bite (AOB) in adults. The focused question was "Is CAT effective for the management of AOB in adults?". Databases were searched without time and language barriers up to and including August 2024 based on pre-specified eligibility criteria. Risk of Bias (RoB) assessment was performed using the Risk-of-Bias-In-Non-randomised-Studies-of-Intervention (ROBINS-I) tool. Meta-analyses were conducted using a random effects model (REM) for change in AOB and cephalometric measurements with an evaluation of the mean difference (MD) and/or standardised mean difference (SMD). The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool was used to assess the quality of evidence. Publication bias was assessed using Funnel plots and Egger's regression test. There were 14 studies included in the qualitative assessment and 12 in the meta-analysis. The RoB was moderate in 13 studies and low in one. The meta-analysis showed significant AOB correction with CAT [(MD) = 2.76 mm, 95% confidence interval (CI): 2.23-3.28] due to maxillary and mandibular incisor extrusion (MD = 0.85 mm, CI: 0.43-1.26 and MD = 0.86 mm, CI: 0.29-1.44, respectively). There were no significant changes identified for maxillary and mandibular molar intrusion or changes in the mandibular plane angle (MPA). The level of confidence was high for AOB correction, incisor extrusion, and molar intrusion and low for MPA. CAT leads to a significant correction of AOB of approximately 2.76 mm, which can be mainly attributed to incisor extrusion.

Orthognatic-Surgical Treatment of class3 openbite with aligner and 3D-Planning

Orthognatic-Surgical Treatment of class3 openbite with aligner and 3D-Planning

Surgical and Camouflage Orthodontic Treatment of Anterior Open Bite: Comparison of Profile Attractiveness.

To evaluate the profile's attractiveness between the different protocols for treating the anterior open bite. The sample comprised 39 patients with anterior open bite treated with or without extractions, divided into two groups: The surgical group (G1) comprised 21 subjects (10 males, 11 females) with a mean initial age of 21.86 years (SD = 5.09), treated with fixed orthodontic appliance followed by orthognathic surgery, for a total mean period of 2.53 years (SD = 0.61). The mean overbite was -5.01 mm (SD = 2.50); The camouflaged group (G2) comprised 18 subjects (9 males, 9 females), with a mean initial age of 20.47 years (SD = 4.19), treated only with fixed orthodontic appliance, for a total mean period of 2.56 years (SD = 0.94). The mean overbite was -4.28 mm (SD = 1.15). Lateral photographs from pretreatment and posttreatment were used. These photographs were evaluated by 46 laypeople and 67 dentists, who rated the attractiveness of each profile from 0 (most unattractive profile) to 10 (most attractive profile). Intergroup comparisons were performed with independent t-tests. Both groups presented improvement in the profile attractiveness with treatment (p < 0.001). Before treatment, the profile of the surgical group was significantly less attractive than the profile of the camouflaged group (p < 0.001). The surgical presented a more attractive profile at the final stage than the camouflaged group (p < 0.001). The surgical group showed a greater improvement in profile attractiveness with treatment than the camouflaged group (p < 0.001). In the final stage, the surgical presented a more attractive and greater improvement in profile attractiveness than the camouflaged group. The laypeople and dentists judged similarly the initial profile attractiveness.

Use of Clear Aligners with a Surgery-First Approach for Treatment of the Anterior Open Bite: A Systematic Review and Comparison with Conventional Fixed Appliances

Use of Clear Aligners with a Surgery-First Approach for Treatment of the Anterior Open Bite: A Systematic Review and Comparison with Conventional Fixed Appliances

Are zygomatic implants an alternative to orthognathic surgery in the treatment of a vertical discrepancy ? A case series to describe an open bite treatment protocol

IntroductionThis report aims to present case series to describe a treatment protocol for correction of severe open bite in non-growing patients MethodologyPatients diagnosed with skeletal open bite malocclusion (overbite range: -3 to -6 mm) were treated using a bonded appliance and skeletal anchorage. Intrusive force was applied between buccal bars of appliance and zygomatic multipurpose implants (MPI). Intrusion was continued until positive overbite occurred. Treatment progressed with conventional fixed orthodontic treatment for alignment and settling. MPIs were retained until the end of treatment for retention of intrusion ResultsClinically effective open bite correction was achieved by intrusion of maxillary buccal segment and mandibular counterclockwise autorotation ConclusionThis protocol includes zygomatic anchorage and an appliance that aims triple intrusion effect through combination of orthodontic and physiological forces. Achieving significant maxillary intrusion, controlling mandibular eruption and maximizing mandibular counterclockwise autorotation are the main outcomes of this protocol.

The Effectiveness of Aligners in the Treatment of Anterior Open Bite in Adult Patients: A Systematic Review and Critical Appraisal

An anterior open bite is a dental malocclusion, the diagnosis of which is fundamental for its treatment. With the evolution of artificial intelligence, it is possible to treat it through the Invisalign G4 protocol, depending on the degree of severity. The aim of this study was to perform a systematic review, based on the PICO strategy, to evaluate the effectiveness of aligners and accessory devices in adult patients with anterior open bites. The search was carried out in the following databases for publications over the last ten years: PubMed, Web of Science, Cochrane Library, and LILACS. The inclusion criteria were clinical studies evaluating adults with anterior open bites (overbites &lt; 0 mm) and orthodontic studies with aligners. The exclusion criteria were studies of cases with dentofacial deformities, previous orthodontic treatment, history of surgery/trauma, or systemic diseases that affect craniofacial growth, as well as animal studies, reviews, and clinical cases. The selection was carried out separately by two researchers. In the four databases, 108 articles were obtained. By reviewing the titles and abstracts and applying the exclusion criteria, 91 articles were eliminated. The seven resulting articles were submitted to the inclusion criteria, two of which were excluded due to their lack of patients presenting an open bite and the absence of aligner treatment. According to the PRISMA method, five studies were selected. The collected data showed an increase in overbites with the use of aligners. The bias assessment was performed with the ROBINS-I tool, indicating a moderate risk of bias. The included studies demonstrated the effectiveness of aligners in the treatment of adults with mild or moderate open bites; however, due to the lack of scientific evidence, it is necessary to carry out randomized studies with the same standardized variables.

Noninvasive conservative management of anterior open bite treated with TADs versus clear aligner therapy.

Anterior open bite can be treated non-surgically via molar intrusion using temporary skeletal devices (TAD). Clear aligner therapy (CAT) is recognized as a viable therapeutic modality for non-extraction treatment of adults with mild open bite. This study aimed to compare the treatment effect and mechanisms of open bite closure between patients treated with braces and TADs double arch intrusion and those treated with CAT. Treatment success at T3 was based on 1- positive overbite on ceph; 2- Change in the vertical dimension 3- post treatment POSI score equal to zero. The TAD group includes 18 consecutively treated patients from the main author. The CAT group consisted of 16 selected patients from three different orthodontists. The observation time points were as follows: pretreatment (T1), end of molar intrusion and positive overbite achieved (T2), end of treatment (T3), at least 6-month follow-up (T4). Treatment changes were assessed by cephalometric analysis and frontal intraoral photo. At the end of treatment, 100% of the patient of the TAD group and 78,6% of the CAT group had a posi score of 0. The TAD group showed a significant reduction in vertical measurements (SN-MPA: -1,55° ± 0.41, LAFH: -3,05 ± 0.51mm, U6-PP: -1.48 ± 0.30mm), but the CAT group did not have significant changes for these variables. Both groups had significant increases in overbite from T1 to T3 (TAD: 4,32 ± 0,5mm; CAT: 2,33 ± 0.56mm), and overbite remained stable at T4. The CAT group did not have a significant upper molar intrusion, but a significant extrusion of 1.22 ± 0.42mm of the lower incisor occurred. The TAD group achieved bite closure by upper molar intrusion, lower molar and incisors vertical control, and mandibular plane counterclockwise rotation, resulting in an improved AP and vertical relationship. The CAT group achieved bite closure through the lower incisor extrusion without significant change in the vertical dimension. This study provides relevant information about the skeletal and dental changes of open bite treatment with TADs double arch intrusion. The comparison with a control group treated with CAT confirms known information.

Oral health-related quality of life, adaptation/discomfort during open bite treatment with spurs: complementary analysis from a randomized clinical trial

This single-center trial aimed to longitudinally compare the oral health-related quality of life (OHRQOL), adaptation and discomfort during anterior open bite (AOB) treatment with lingual spurs and build-ups (SBU) versus spurs only (S) approaches. Children (7–11 years) with AOB were randomly allocated into two treatment groups (SBU or S). The Child Perception Questionnaire (CPQ8–10) was applied 1 and 12 months after installation of the appliances. Questionnaires evaluating functional adaptation and discomfort during the first month of treatment were also applied. A visual analog scale (VAS) was used in these questionnaires. Generalized mixed models were used for analyzing OHRQOL and discomfort data. Generalized linear models were used to assess adaptation outcomes (α = 0.05). The SBU group included 24 patients (7 males and 17 females; mean age 8.2 years) and the S group included 25 patients (11 males and 14 females; mean age 8.3 years). Regardless of the treatment type, overall OHRQOL scores at 12 months were 0.69 times those recorded at 1 month after the appliances installation (i.e., ~ 31% reduction; exp (β) = 0.69; 95% CI: 0.55, 0.88). A significant interaction between treatment and time was detected for the ‘functional limitations’ domain. For this domain, a significant improvement from the first to the twelfth month was observed in the S group (P < 0.001). Patients in both treatment groups showed similar and easy adaptation to the appliances. Independent of the type of treatment, tongue-related discomfort decreased over time. One week and one month after the appliance’s delivery, the discomfort scores were 0.19 (i.e., ~ 81% reduction; exp (β) = 0.19; 95% CI: 0.13, 0.28; P < 0.001) and 0.02 (i.e., ~ 98% reduction; exp (β) = 0.02; 95% CI: 0.01, 0.07; P < 0.001) times, respectively, those issued immediately after the installation of the appliances. Regardless of treatment type; overall OHRQOL improved from the first to the twelfth month of AOB treatment. The functional limitations score decreased in the S group. Children showed easy adaptation, and their discomfort decreased 1 week after the installation of the appliances.Trial registration: Clinicaltrials.gov; NCT03702881, date of registration: October 11, 2018.

Highlights of orthognathic surgery in class II patients: a systematic review

Introduction: Orthognathic surgery is indicated to modify the position of the maxillomandibular structure, which may cause changes in the sagittal position of the mandibular condyle in individuals with retrognathism and mandibular prognathism. In the context of orthognathic surgery, anterior open bite (AOB) is an easily recognized malocclusion and presents only aesthetic and functional problems. Objective: Foi desenvolver uma revisão sistemática para apresentar as principais considerações da cirurgia ortognática em pacientes classe II. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 88 articles were found, 40 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=57.5%&gt;50%. The etiology of anterior open bite is multifactorial and may be caused by environmental and hereditary factors. Class II patients may have significantly greater amounts of lateral and inferior translation than class III patients. Two-jaw surgery for open bite correction led to different directions and amounts of condylar rotational displacement in patients with skeletal class II malocclusion. Treatment can be carried out through preventive, interceptive, corrective, or even surgical treatments. The differentiated bonding of brackets to the anterior teeth is also a very useful resource for the treatment of anterior open bite.

Effects of posterior intrusion using skeletal anchorage on treating anterior open bite: A systematic review and meta-analysis.

Posterior intrusion with skeletal anchorage is one of the effective methods in the treatment of anterior open bite. Knowing the effects of posterior intrusion, the amount of possible molar intrusion using skeletal anchorage, and its impact on clinical and cephalometric indicators can help the clinician choose the optimal treatment method, especially in borderline surgical cases. In this systematic review, a series of articles were collected through a systematic search in databases, and the titles and summaries of all these articles were reviewed. After removing the irrelevant articles, the full texts of the related articles were read carefully, and their validity was evaluated. Only RCTs and observational studies that complied with PICO questions were included. The Cochrane Risk of Bias 2.0 (RoB 2), ROBINS-I, and GRADE were used to assess the risk of bias in the included studies. The relevant information on selected articles was extracted, and a meta-analysis was performed with Review Manager 5.4 software. The meta-analysis revealed a significant average molar intrusion of 2.89 mm using temporary anchorage devices (TADs). A subgroup analysis showed that miniplates achieved greater intrusion (3.29 mm) compared to miniscrews (2.25 mm) (P=0.03). The level of applied force did not significantly affect the degree of intrusion. Dental parameters such as overbite and overjet were notably altered, with overbite increasing by 4.81 mm and overjet decreasing by 2.06 mm on average. As for the skeletal cephalometric characteristics, SNB, ANB, and SN-Pog increased while mandibular plane angle and lower anterior facial height (LAFH) decreased, and these changes were significant. Meanwhile, SNA and palatal angle changes were not significant. TADs have proved effective in achieving significant intrusion of maxillary molars, leading to marked improvements in dental and skeletal characteristics in patients with open bite malocclusion. Miniplates proved more effective in achieving greater intrusion.

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

Efficiency of Aligners in Correcting Anterior Open Bite: A Systematic Literature Review

Background: The utilization of orthodontic aligners for treating various malocclusions has significantly increased in recent years. However, there is uncertainty regarding the evidence supporting their effectiveness in correcting anterior open bite. Objective: The purpose of this study was to systematically review the literature and evaluate the clinical effectiveness of clear aligners in correcting anterior open bite based on the available evidence. Materials and methods: A total of three databases (Pubmed, Sciences Direct and Google Scholar) were searched until March 2023, in addition to a manual search in the following journals: the American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontist, and the European Journal of Orthodontics. Prospective and retrospective studies assessing the ability of aligners in achieving incisal extrusion and molar intrusion movements published during the last 10 years in English were eligible to be selected. Study selection and data extraction were undertaken independently by two reviewers. Risk-of-bias (RoB) assessment was evaluated using the study quality assesment tool of NHLBI, NIH. The reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Nineteen relevant articles were included in the analysis, comprising four prospective non-randomized and fifteen retrospective non-randomized studies. Among these, four studies compared the efficacy of aligners versus fixed appliances in correcting anterior open bite, while fourteen papers evaluated the overall effectiveness of aligners in treating this malocclusion. The risk of bias was categorized as high in one study, moderate in eight studies, and low in ten studies. Extrusion was found to be easily achievable with aligners, with the actual quantity of extrusion often surpassing predictions in the majority of studies. The mean reported extrusion amounted to 1.8mm. Additionally, the mean reported intrusion was 0.75mm. Conclusion: It is evident that aligners are an effective option for the treatment of anterior open bite, this effectiveness is achieved by combining the extrusion and palatal tipping of the anterior segments with the intrusion of the lateral segments, resulting in a counterclockwise rotation of the mandible. Moreover, aligner treatment may be a valid alternative to conventional orthodontic therapy, but it does not appear to provide better control over the vertical dimension compared to fixed orthodontic appliances in adult patients.

Aesthetic Solutions in The Treatment of Open Bite

Open chew is a frequent malocclusion that can have terrible consequences on each characteristic and aesthetics. Patients with open chunk regularly trip difficulties in biting, chewing, and speech, main to a sizable have an impact on on their fine of life. Fortunately, advances in orthodontics have furnished quite a number aesthetic options to right open chunk and enhance oral function. This article will discover the distinct therapy picks reachable and spotlight the significance of aesthetics in accomplishing profitable outcomes.

Open Bite Treatment with Combined Aligners and Myofunctional Appliances: A Case Report

This case report describes an 18-year-old female patient with a skeletal class I pattern, mandibular asymmetry, a molar class III on the right side, a molar class II on the left side, and an anterior open bite (AOB). Treatment of AOB is often difficult for orthodontists and a multidisciplinary approach is sometimes required to rehabilitate the correct function and posture of the tongue. In this case the AOB was treated using the Nuvola® OP System: a treatment system that combines orthodontic aligners and a myofunctional elastodontic device called Freedom. An upper molar intrusion with miniscrews was performed during the first phase of the treatment programme, and then the aligner treatment began. The Nuvola® OP System ’s aligners are characterized by lingual pins that guide the tongue to the palatal spot position and take advantage of tongue function. The patient was instructed to wear the Freedom device for 30 min a day and to clench every 3 s with closed lips while wearing the aligners. These exercises improve the fitting of the aligners, improve the tongue’s posture, and take advantage of the masticatory forces to resolve the malocclusion. The patient was successfully treated, thus demonstrating that the Nuvola® OP System is a valid alternative for the treatment of AOB.

A 3D Finite Element Analysis of biomechanical effects on teeth and bone during true intrusion of posteriors using miniscrews

The primary objective of this study was to investigate the biomechanical effects and stresses on bone, PDL, cementum and displacement along X-,Y- and Z-axis during true intrusion of molars using mini-implants with finite element analysis; the secondary objective of the study was to find out the best method for posterior intrusion in clinical practice. A 3D finite element method was used to simulate true molar intrusion using sliding mechanics. Two groups were made, with mini-implants placed on buccal side and palatal side with a cap splint for MODEL1, and a single mini-implant placed buccally with transpalatal arch (TPA) for MODEL2. The material characteristics which include the Young's modulus and Poison's ratio were assigned. von Mises stress, principal stress on PDL and alveolar bone, displacements in all the 3 planes were determined. Bone stress patterns showed compressive stresses on the buccal aspect and tensile stresses on the palatal aspect for both MODELS. Stresses in the PDL and cementum were mainly concentrated in the apex region, with a more uniform distribution of stresses for MODEL 1. Tooth displacement showed true intrusion for both MODELS, i.e. the Z axis, and a more controlled buccal tipping for MODEL 1. Of the modalities compared, the best controlled tooth movements for posterior intrusion in the treatment of open bite were obtained with mini-implants placed with a cap splint (MODEL 1).

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.

Anterior Open Bite Treatment in the Mixed Dentition: a Brief Review and Case Report

Anterior open bite (AOB) is a vertical plane malocclusion characterized by a negative vertical overbite and can be classified according to its nature: dentoalveolar or skeletal. The dentoalveolar anterior open bite (DAOB) occurs in individuals who have a good relationship between the bone bases and its etiology is associated with environmental factors. DAOBS´s treatment tends to have a favorable prognosis and it's up to the dentist to choose the most adequate method in each case. Thus, the objective of this study is to present a case report of DAOB. Female patient of 6 years old attended the Preventive Orthodontics Clinic of the Faculty of Dentistry of Araçatuba - UNESP, having as main complaint “open bite”. In the anamnesis the patient revealed that used a pacifier and presented a digital sucking habit. The patient was in the first transitional period of mixed dentition with permanent incisors and first molars partially erupted. The diagnosis was of Angle Class I malocclusion with dentoalveolar anterior open bite and dentoalveolar anterior crossbite of the deciduous right maxillary canine. The bi-helix with crib appliance was installed and the patient was oriented to perform myofunctional exercises daily. This therapeutic protocol represents an efficient and effective approach for the correction of DAOBs providing improved aesthetics, social well-being and a more appropriate and correct occlusion that allows oral functions (deglutition, speech and chewing) to work properly. The results acquired through this treatment are essentially of dentoalveolar nature.

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.

Surgical vs nonsurgical treatments in patients with anterior open-bite have similar effects in occlusal function: A 2-year follow-up study

This study aimed to investigate changes in bite force (BF) and occlusal contact area after anterior open-bite (AOB) treatment and compare the changes in surgical vs nonsurgical treatment. This retrospective study included patients with AOB compared with normal occlusion. AOB was corrected by either intrusion of the maxillary molars (intrusion group, n= 19) or orthognathic surgery (surgery group, n= 37). The control group (n= 35) had a normal overbite relationship. Records of lateral cephalograms, BF, and occlusal contact area taken before (T0), immediately after (T1), and 2 years after (T2) orthodontic treatment were compared within and among the 3 groups. The open-bite group, including intrusion and surgery groups, had a lower BF and less occlusal contact area than the control group at T0 and T1 (P<0.001). However, there were no significant differences among the 3 groups at T2 (P>0.05). The intrusion and surgery groups showed no significant differences throughout the observation period extending from T0 to T2 (P>0.05). Although BF and occlusal contact area decreased at T1 compared with T0, they increased during retention and showed higher values at T2 than at T0. Treatment of AOB improved BF and occlusal contact area 2 years posttreatment. Orthognathic surgery and molar intrusion using orthodontic miniscrews can improve occlusal function similarly. Orthodontists can select either method depending on malocclusion severity and patient demand.

Anterior open bite treatment using Balters class II bionator: a case report

There are several reasons for the onset of malocclusion, which promotes disharmonious development of the craniofacial structure and may involve various factors such as incorrect positioning of teeth, maxilla, mandible, lips, tongue, and/or cheeks, possibly accompanied by deleterious oral habits. Malocclusion is a common finding that affects facial aesthetics, smile, as well as masticatory and respiratory functions, occurring in a large portion of the world’s population. Hence, a correct and early diagnosis is necessary for malocclusion treatment. There are various available treatments aiming for early correction of malocclusions. This clinical case report will describe a possible treatment for correcting an anterior open bite during the mixed dentition associated with a deleterious oral habit. The Balters’ Bionator is a functional orthopedic dento-muco-supported appliance that harmonizes the muscles of the tongue, lips, and cheeks, and treats skeletal discrepancies. At the end of this orthopedic treatment stage, the patient achieved the objectives of this work and will continue her care in a pediatric dental clinical setting at the Federal University of Amazonas-UFAM for further analysis and additional dentomuco-skeletal corrections.