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Alam MK, Alayyash A. Management Strategies for Open Bite Relapse: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e56285. [PMID: 38623106 PMCID: PMC11018291 DOI: 10.7759/cureus.56285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/15/2024] [Indexed: 04/17/2024] Open
Abstract
The purpose of orthodontic therapy is to correct malocclusion and produce a stable outcome that endures over time. Long-term stability can be difficult to achieve, and many patients relapse after treatment, particularly in instances of open bite relapse (OBR). This systematic review aimed to analyze different types of management strategies for OBR and conduct a meta-analysis to find the best method of dealing with relapse. A comprehensive search was carried out across six major online databases using relevant keywords pertaining to our study, including "open bite relapse," "orthodontic retention," "orthodontic surgery," "orthodontic appliance," "orthodontic management," "orthodontic treatment," "orofacial myofunctional therapy (OMT)," "skeletal anchorage," and "treatment follow-up period." Eleven studies were selected after the application of relevant inclusion and exclusion strategies. The mean follow-up period of treatment for the studies ranged from six months to 4.5 years. Of all the management strategies assessed, OMT was found to be the least effective for OBR management. Surgical management modalities, such as mandibular repositioning and molar intrusion using skeletal anchorage, in conjunction with the usage of orthodontic appliances, were found to be noticeably effective, especially in the cases of participants who were <18 years of age. However, when utilized on a singular basis, either of them was found to be lacking the desired effect. The overall odds ratio (OR) of 0.48 (0.37, 0.64) and risk ratio (RR) of 0.62 (0.51, 0.74) were obtained after the meta-analysis of the different interventions for OBR, indicating statistical significance. There were only 11 studies included in the study, so it's possible that not all management strategies for OBR were fully understood. The limited number of studies may also have affected the generalizability of the findings. Although statistical differences were obtained to a certain degree, more clinical trials are needed to assess the effect of such surgical modalities as a viable management tool for OBR, since these represent a significant limiting factor in terms of the overall cost of the treatment placed upon the patient. Prior to the start of the research, registration was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The research protocol was created to meet the goals and was properly filed with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023401991).
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Affiliation(s)
- Mohammad K Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, SAU
| | - Afnan Alayyash
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, SAU
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Suh H, Garnett BS, Mahood K, Boyd RL, Oh H. Short-term stability of anterior open bite treatment with clear aligners in adults. Am J Orthod Dentofacial Orthop 2023; 164:774-782. [PMID: 37552148 DOI: 10.1016/j.ajodo.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners. METHODS This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse. RESULTS The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant. CONCLUSIONS AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.
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Affiliation(s)
- Heeyeon Suh
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Bella Shen Garnett
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif; Private practice, San Francisco, Calif
| | - Kimberly Mahood
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Robert L Boyd
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Heesoo Oh
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif.
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Gillgrass T. The orthodontic management of patients with cleft lip and palate: from the permanent dentition and the adult returning to the service. Br Dent J 2023; 234:892-898. [PMID: 37349437 DOI: 10.1038/s41415-023-5956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/09/2023] [Accepted: 03/18/2023] [Indexed: 06/24/2023]
Abstract
This is the second of two papers outlining the orthodontic management of patients with cleft lip and palate. The first paper reviewed orthodontic input into children with cleft lip and palate from birth to the late mixed dentition before definitive orthodontics. In this second paper, I will discuss tooth management across the grafted cleft site and its impact on the bone graft itself. I will also discuss the some of the challenges of the adult patient returning to the service.
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Affiliation(s)
- Toby Gillgrass
- Cleft Surgical Service for Scotland & Glasgow Dental Hospital and School, Glasgow, United Kingdom.
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4
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Nonsurgical Orthodontic Treatment of a Severe Open Bite Case Using Miniscrews with Modified Multiloop Edgewise Arch Wire Technique. Case Rep Dent 2022; 2022:1844167. [PMID: 36157202 PMCID: PMC9499781 DOI: 10.1155/2022/1844167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
Skeletal open bite is one of the most challenging malocclusions to treat and maintain due to the difficulty and instability of correction. Although a combination of orthodontic treatment and orthognathic surgery may be the ideal approach in most cases, the complications, risks, and costs of surgery have sparked an interest in alternative treatment options that use temporary anchorage devices to achieve orthognathic-like effects. Adult patients can be treated without the need for special compliance using temporary anchorage devices such as miniscrews. This case report demonstrates a goal-oriented strategy for nonsurgical treatment of a complex skeletal open bite malocclusion in an adult patient using miniscrews and a modified multiloop edgewise arch wire (MEAW) technique, with the results evaluated clinically and cephalometrically.
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Schneider-Moser UEM, Moser L. Very early orthodontic treatment: when, why and how? Dental Press J Orthod 2022; 27:e22spe2. [PMID: 35703618 PMCID: PMC9191856 DOI: 10.1590/2177-6709.27.2.e22spe2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction: Several orthodontic problems should already be treated at an early age to prevent the necessity of future complex and expensive procedures. Scientific evidence suggests that posterior crossbites, mild to moderate Class III, as well as certain Class II malocclusions, open bites and arch length discrepancies can benefit from simple, but efficient interceptive therapy. Objective: To summarize the existing evidence-based literature on early orthodontic treatment, and to illustrate its application and effectiveness by showcasing multiple clinical examples. Conclusion: Early short-term interceptive orthodontic treatment with simple appliances, in the deciduous or early mixed dentition phase, can efficiently correct certain malocclusions and help to either reduce the complexity or even avoid the necessity of complex and expensive procedures during puberty. For certain patients with significant arch length discrepancy the concept of serial extractions should be part of the orthodontic armamentarium.
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Affiliation(s)
- Ute E M Schneider-Moser
- Private practice (Bolzano, Italy).,University of Ferrara, Ferrara School of Orthodontics (Ferrara, Italy).,University of Pennsylvania, School of Dental Medicine (Philadelphia/PA, USA)
| | - Lorenz Moser
- Private practice (Bolzano, Italy).,University of Ferrara, Ferrara School of Orthodontics (Ferrara, Italy)
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Arnett GW, D'Agostino A, Grendene E, McLaughlin RP, Trevisiol L. Combined orthodontic and surgical open bite correction. Angle Orthod 2022; 92:431-445. [PMID: 35293981 DOI: 10.2319/123121-959.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To present a clinical description of the team's treatment techniques. MATERIALS AND METHODS In Part 1, 30 patients underwent segmental maxillary orthodontics, multisegment Le Fort I, and bilateral sagittal osteotomies of the mandible. Part 1 reported excellent occlusal stability at a mean follow-up of 49.43 months (range, 36-92 months). Cases presented in Part 2 were selected based on availability of excellent technique photographs. The same techniques described in Part 2 cases were used on all Part 1 patients. RESULTS The coordination of arch widths and forms, overbite, overjet, and maxillary curve of Spee corrections were stable using the team protocols for orthodontic and surgical treatment. CONCLUSIONS In the study group, long-term three-dimensionally stable occlusal results were achieved. To duplicate these results, specific orthodontic preparation, intraoperative surgical steps, and postsurgical steps must be carefully planned and executed. These steps are described in this article, Part 2.
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Arnett GW, Trevisiol L, Grendene E, McLaughlin RP, D'Agostino A. Combined orthodontic and surgical open bite correction. Angle Orthod 2022; 92:161-172. [PMID: 34986216 PMCID: PMC8887413 DOI: 10.2319/101921-779.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVES To examine the stability of combined surgical and orthodontic bite correction with emphasis on open-bite closure. All study patients were treated with strict and consistent orthodontic and surgical protocols. MATERIALS AND METHODS Study inclusion required all patients to have anterior open bites, maxillary accentuated curve of Spee, 36-month minimum follow-up, and no temporomandibular joint pathology. Thirty patients met the inclusion/exclusion criteria. Importantly, segmental upper arch orthodontic preparation (performed by EG) was used. Surgery consisted of a multisegment Le Fort I (MSLFI) combined with a bilateral sagittal osteotomies (BSSO). Surgery was performed (by ADA and LT) at the Department of Dentistry and Maxillofacial Surgery of the University of Verona, Italy. RESULTS The long-term open bite and overjet relapse were not statistically significant. The mean transverse relapse of the upper and lower molars was statistically significant. Of great importance, the upper and lower arch widths narrowed together, maintaining intercuspation of the posterior dentition which prevented anterior open bites from developing. CONCLUSIONS This study revealed stability of three-dimensional occlusal correction including anterior open bite. Stable open bite closure was achieved by using rigid protocols for orthodontic preparation, surgical techniques, surgical follow-up, and orthodontic finishing.
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Malara P, Bierbaum S, Malara B. Outcomes and Stability of Anterior Open Bite Treatment with Skeletal Anchorage in Non-Growing Patients and Adults Compared to the Results of Orthognathic Surgery Procedures: A Systematic Review. J Clin Med 2021; 10:jcm10235682. [PMID: 34884384 PMCID: PMC8658589 DOI: 10.3390/jcm10235682] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/15/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of this review is to evaluate, on the basis of the available literature, if anterior open bite (AOB) can be successfully treated with the intrusion of molar teeth using skeletal anchorage in non-growing patients and adults and if this treatment modality provides comparable results to those obtained by orthognathic surgery procedures. METHODS A systematic review of published data in major databases from 2000 to 2021 was performed. RESULTS In total, 92 articles were included in title and abstract screening, and only 16 articles (11 concerning AOB correction by molar intrusion with skeletal anchorage, and five considering AOB treatment by orthognathic surgical intervention) qualified for thorough data extraction and analysis. CONCLUSIONS On the basis of this review, it seems to be possible to obtain successful results for AOB treatment in non-growing patients and adults by means of the intrusion of molar teeth with skeletal anchorage. However, due to the different methods of assessing treatment outcomes used by different authors, it is not possible to state conclusively whether the treatment of AOB by means of molar intrusion with skeletal anchorage provides long-term results that are comparable to orthognathic surgery procedures.
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Affiliation(s)
- Piotr Malara
- Department of Maxillofacial Surgery for Children, Chorzow Hospital for Paediatrics and Oncology, 41-500 Chorzów, Poland
- Postgraduate Educational Centre of Dentistry DENTARIS, School of Medicine, Katowice Business School, 40-659 Katowice, Poland
- Correspondence:
| | - Susanne Bierbaum
- Max Bergmann Center of Biomaterials, Technische Universität Dresden, 01069 Dresden, Germany;
- International Medical College, 48143 Münster, Germany
| | - Beata Malara
- Department of Facial Aesthetics and Cosmetology, School of Medicine, Katowice Business School, 40-659 Katowice, Poland;
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Lopes BK, Scheicher GV, Matsumoto MA, Romano FL. Rapid Palatal Expansion and Utilization of E-space in Mixed Dentition: Mechanics that Helps in the Corrective Orthodontic Treatment. Int J Clin Pediatr Dent 2021; 14:133-139. [PMID: 34326599 PMCID: PMC8311780 DOI: 10.5005/jp-journals-10005-1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim and objective The objective of this article was to report two clinical cases, showing the benefits of interceptive treatment using rapid palatal expansion (RPE) and the preservation of E-space. Background It is important to follow-up child throughout its development to detect irregularities in their occlusion and to avoid or attenuate orthodontic treatments in the future. Posterior crossbite and transverse maxillary deficiency can easily be corrected by RPE that enhances the width of the maxilla and promotes a gain of space in the arch. Another way to gain space in the arch is by using the E-space, which is the difference between the mesiodistal distance of the second primary molar in relation to the second premolar. This additional space can be used to resolve negative, mild, or moderate crowding. Case descriptions Two clinical cases that presented malocclusions due to lack of space and maxillary deficiency, along with clinical technic of how the RPE and E-space can be used to bring those patients back to normality. Conclusion We concluded that with a right diagnosis, correct interceptive timing, and using what growth provides, the development can be reestablished. Clinical significance The clinical importance of this report is that RPE and E-space are efficient interceptive orthodontic treatments to correct skeletal posterior crossbite (SPC) and gain space in dental arches. How to cite this article Lopes BKB, Scheicher GV, Matsumoto MAN, et al. Rapid Palatal Expansion and Utilization of E-space in Mixed Dentition: Mechanics that Helps in the Corrective Orthodontic Treatment. Int J Clin Pediatr Dent 2021;14(1):133–139.
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Affiliation(s)
- Beatriz Kb Lopes
- Department of Paediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Gabriel V Scheicher
- Department of Paediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mirian An Matsumoto
- Department of Paediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fábio L Romano
- Department of Paediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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The rationale for orthodontic retention: piecing together the jigsaw. Br Dent J 2021; 230:739-749. [PMID: 34117429 DOI: 10.1038/s41415-021-3012-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.
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Hong H, Zeng Y, Chen X, Peng C, Deng J, Zhang X, Deng L, Xie Y, Wu L. Electromyographic features and efficacy of orofacial myofunctional treatment for skeletal anterior open bite in adolescents: an exploratory study. BMC Oral Health 2021; 21:242. [PMID: 33962610 PMCID: PMC8103572 DOI: 10.1186/s12903-021-01605-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the multifactorial aetiology and unpredictable long-term stability, skeletal anterior open bite (SAOB) is one of the most intractable conditions for orthodontists. The abnormal orofacial myofunctional status (OMS) may be a major risk factor contributing to the development and relapse of SAOB. This study is aimed at evaluating the OMS and the efficacy of orofacial myofunctional therapy (OMT) alone for SAOB subjects. METHODS Eighteen adolescents with SAOB (4 males, 14 females; age: 12-18 years) and eighteen adolescents with normal occlusion (2 males, 16 females; age: 12-18 years) were selected. The electromyographic activity (EMGA) associated with mastication and closed mouth state was measured. Lateral cephalography was used to evaluate craniofacial morphology. Wilcoxon signed rank tests and t-tests were performed to evaluate myofunctional and morphological differences. Pearson or Spearman correlation analysis was used to investigate the correlations between EMGA and morphological characteristics. SAOB subjects were given OMT for 3 months, and the EMGA was compared between before and after OMT. RESULTS During rest, anterior temporalis activity (TAA) and mentalis muscle activity (MEA) increased in SAOB subjects, but TAA and masseter muscle activity (MMA) decreased in the intercuspal position (ICP); and upper orbicularis activity (UOA) and MEA significantly increased during lip sealing and swallowing (P < 0.05). Morphological evaluation revealed increases in the FMA, GoGn-SN, ANS-Me, N-Me, L1-MP, U6-PP, and L6-MP and decreases in the angle of the axis of the upper and lower central incisors and OB in SAOB subjects (P < 0.05). TAA, MMA and anterior digastric activity (DAA) in the ICP were negatively correlated with vertical height and positively correlated to incisor protrusion. MEA was positively correlated with vertical height and negatively correlated with incisor protrusion; and the UOA showed a similar correlation in ICP, during sealing lip and swallowing. After SAOB subjects received OMT, MEA during rest and TAA, MMA and DAA in the ICP increased, while UOA and MEA decreased (P < 0.05). CONCLUSION SAOB subjects showed abnormal OMS features including aberrant swallowing patterns and weak masticatory muscles, which were interrelated with the craniofacial dysmorphology features including a greater anterior facial height and incisor protrusion. Furthermore, OMT contributes to OMS harmonization, indicating its therapeutic prospect in SAOB.
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Affiliation(s)
- Hong Hong
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
| | - Yue Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
| | - Xiaomin Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Guangzhou Panyu Central Hospital, Guangzhou, 511400, People's Republic of China
| | - Caixia Peng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Department of Stomatology, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518106, People's Republic of China
| | - Jianqing Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, People's Republic of China
| | - Xueqin Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Department of Stomatology, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518106, People's Republic of China
| | - Lidi Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China
| | - Yongjian Xie
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China
| | - Liping Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, People's Republic of China.
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González Espinosa D, de Oliveira Moreira PE, da Sousa AS, Flores-Mir C, Normando D. Stability of anterior open bite treatment with molar intrusion using skeletal anchorage: a systematic review and meta-analysis. Prog Orthod 2020; 21:35. [PMID: 32888097 PMCID: PMC7474024 DOI: 10.1186/s40510-020-00328-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/15/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment. METHODS This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate. RESULTS Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars. CONCLUSION The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.
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Affiliation(s)
- Daybelis González Espinosa
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil.,Facultad de Odontologia, Universidad Católica Redemptoris Mater, Managuá, Nicaragua
| | - Paulo Eliezer de Oliveira Moreira
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil
| | - Amanda Silva da Sousa
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil
| | - Carlos Flores-Mir
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - David Normando
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil.
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Foosiri P, Changsiripun C. Stability of anterior open bite in permanent dentition treated using extraction or non-extraction methods: A systematic review and meta-analysis of each method. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.odw.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Pimchanok Foosiri
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road , Bangkok Thailand
| | - Chidsanu Changsiripun
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road , Bangkok Thailand
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Zupnik JT, Ioshida M, Yatabe M, Ruellas ACO, Gomes LR, Aronovich S, Benavides E, Edwards SP, Paniagua B, Cevidanes LHS. Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions. Int J Oral Maxillofac Surg 2019; 48:739-745. [PMID: 30712988 DOI: 10.1016/j.ijom.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/20/2018] [Accepted: 01/08/2019] [Indexed: 11/17/2022]
Abstract
The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. The directions and amounts of condylar displacement were assessed by intra- and inter-class Mann-Whitney U-test or t-test. Class II patients presented significantly greater amounts of lateral (P=0.002) and inferior (P=0.038) translation than class III patients. The magnitudes of condylar translational displacements were small for both groups. Skeletal class III patients had predominantly medial (P=0.024) and superior (P=0.047) condylar translation. Skeletal class II patients presented greater condylar counterclockwise pitch (P=0.007) than class III patients. Two-jaw surgery for the correction of open bite led to different directions and amounts of condylar rotational displacement in patients with skeletal class II compared to class III malocclusion, with greater rotational than translational displacements.
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Affiliation(s)
- J T Zupnik
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Ioshida
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA.
| | - A C O Ruellas
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L R Gomes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - S Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
| | - E Benavides
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - S P Edwards
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - L H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
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Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open bite. Radiol Oncol 2018; 52:250-256. [PMID: 30210041 PMCID: PMC6137359 DOI: 10.2478/raon-2018-0032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 07/13/2018] [Indexed: 11/20/2022] Open
Abstract
Background Tongue posture plays an important role in the etiology of anterior open bite (AOB) and articulation disorders, and is crucial for AOB treatment planning and posttreatment stability. Clinical assessment of tongue posture in children is unreliable due to anatomical limitations. The aim of the study was to present functional diagnostics using three-dimensional ultrasound (3DUS) assessment of resting tongue posture in comparison to clinical assessment, and the associations between the improper tongue posture, otorhinolaryngological characteristics, and articulation disorders in preschool children with AOB. Patients and methods A cross-sectional study included 446 children, aged 3-7 years, 236 boys and 210 girls, examined by an orthodontist to detect the prevalence of AOB. The AOB was present in 32 children. The control group consisted of 43 children randomly selected from the participants with normocclusion. An orthodontist, an ear, nose and throat (ENT) specialist and a speech therapist assessed orofacial and ENT conditions, oral habits, and articulation disorders in the AOB group and control group. Tongue posture was also assessed by an experienced radiologist, using 3DUS. The 3DUS assessment of tongue posture was compared to the clinical assessment of orthodontist and ENT specialist. Results The prevalence of AOB was 7.2%. The AOB group and the control group significantly differed regarding improper tongue posture (p < 0.001), and articulation disorders (p < 0.001). In children without articulation disorders from both groups, the improper tongue posture occured less frequently than in children with articulation disorders (p < 0.001). After age adjustment, a statistical regression model showed that the children with the improper tongue posture had higher odds ratios for the presence of AOB (OR 14.63; p < 0.001) than the others. When articulation disorders were included in the model, these odds ratios for the AOB became insignificant (p = 0.177). There was a strong association between the improper tongue posture and articulation disorders (p = 0.002). The 3DUS detected the highest number of children with improper resting tongue posture, though there was no significant difference between the 3DUS and clinical assessments done by orthodontist and ENT specialist. Conclusions The 3DUS has proved to be an objective, non-invasive, radiation free method for the assessment of tongue posture and could become an important tool in functional diagnostics and early rehabilitation in preschool children with speech irregularities and irregular tongue posture and malocclusion in order to enable optimal conditions for articulation development.
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Tanny L, Huang B, Naung NY, Currie G. Non-orthodontic intervention and non-nutritive sucking behaviours: A literature review. Kaohsiung J Med Sci 2018; 34:215-222. [PMID: 29655410 DOI: 10.1016/j.kjms.2018.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/24/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022] Open
Abstract
Anterior open bite (AOB) is one of the most complex malocclusions to manage. AOB is caused by either by skeletal, genetic or environmental factors. Numerous treatment options are currently utilised to manage AOB. These vary from non-invasive behavioural shaping to orthodontic and surgical interventions. This paper reviews the available orthodontic and non-orthodontic interventions used in the management of AOB. The literature review was carried out using the PubMed search engine from the first of January 2000 to the first of June 2017. Two major keywords (open bite and anterior open bite) were used in addition to 23 minor keywords in the review. AOB is one of the most complex malocclusions to treat with high relapse rates. Long term outcome in treatments of patients with AOB was substantially low. Relapse rates were not taken into consideration for some of the literature reviewed. Despite limitations of the literature, it is recommended that orofacial myofunctional therapy (OMT) and non-orthodontic intervention (NOI) be used in conjunction as an effective treatment option for Anterior Open Bite.
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Affiliation(s)
- Liyana Tanny
- School of Dentistry and Health Sciences, Charles Sturt University, Australia
| | - Boyen Huang
- School of Dentistry and Health Sciences, Charles Sturt University, Australia.
| | - Noel Ye Naung
- School of Dentistry and Health Sciences, Charles Sturt University, Australia
| | - Geoffrey Currie
- School of Dentistry and Health Sciences, Charles Sturt University, Australia
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17
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Cambiano AO, Janson G, Lorenzoni DC, Garib DG, Dávalos DT. Nonsurgical treatment and stability of an adult with a severe anterior open-bite malocclusion. J Orthod Sci 2018; 7:2. [PMID: 29765914 PMCID: PMC5952238 DOI: 10.4103/jos.jos_69_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES A skeletal anterior open-bite is a challenging malocclusion for the orthodontist due to the difficulty and instability of correction. Treatment options for the adult patient include extractions, anterior extrusion with intermaxillary elastics, posterior intrusion using skeletal anchorage, occlusal adjustment, and orthognathic surgery. Patient compliance plays a key role in posttreatment stability. The present case report demonstrates the orthodontic treatment of an adult patient who presented with a complex open-bite malocclusion. MATERIALS AND METHODS Treatment involved the placement of four miniscrews to assist intrusion of maxillary molars by applying posterior vertical maxillary elastics and extrusion of the anterior segments using anterior vertical interarch elastics. RESULTS Ideal intercuspation was successfully achieved and good stability was maintained during 3 years following treatment. CONCLUSION The intrusion of the maxillary molars with miniscrews is an interesting option in selected cases of skeletal anterior open bite. The retention protocol should be specific in these cases.
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Affiliation(s)
- Aldo Otazú Cambiano
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | | | - Daniela Gamba Garib
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
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18
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Al Hamadi W, Saleh F, Kaddouha M. Orthodontic Treatment Timing and Modalities in Anterior Open Bite: Case Series Study. Open Dent J 2017; 11:581-594. [PMID: 29299074 PMCID: PMC5725483 DOI: 10.2174/1874210601711010581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/16/2017] [Accepted: 10/18/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was to present early and adult cases of anterior open bite that were treated efficiently using different treatment approaches and mechanics. MATERIALS AND METHODS Five patients of different age groups (from 7 to 27 years), suffering from a clear Anterior open bite deformity, were properly diagnosed and relevant treatment modality for each was selected. RESULTS Positive overbite was efficiently achieved for all patients. CONCLUSION Patient compliance is a key factor in using removable habit breakers. However, fixed palatal crib gave the same results but in shorter time. Anterior open bite of skeletal components should be thoroughly evaluated before selecting camouflage or orthognathic surgery treatment modality.
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Affiliation(s)
| | - Fayez Saleh
- Department of Orthodontics, Beirut Arab University, Beirut, Lebanon
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19
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Brahem EB, Holm B, Sonnesen L, Worsaae N, Gotfredsen K. Positional changes of maxillary central incisors following orthodontic treatment using single-crown implants as fixed reference markers. Clin Oral Implants Res 2017. [DOI: 10.1111/clr.13026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- E. B. Brahem
- Oral Rehabilitation; Department of Odontology; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Orthodontics; Department of Odontology; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - B. Holm
- Oral Rehabilitation; Department of Odontology; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - L. Sonnesen
- Orthodontics; Department of Odontology; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - N. Worsaae
- Department of Oral & Maxillofacial Surgery; Rigshospitalet; Copenhagen Denmark
| | - K. Gotfredsen
- Oral Rehabilitation; Department of Odontology; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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20
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Liao J, He S, Hu Z, Zou S. Severe open bite with mandibular asymmetry treated using micro-implant anchorage. AUSTRALASIAN ORTHODONTIC JOURNAL 2017. [DOI: 10.21307/aoj-2020-104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Abstract
Background
This case report describes the orthodontic treatment of a 20 year-old female who presented with a severe anterior open bite, increased lower facial height and mandibular asymmetry. The patient was diagnosed with a Class I skeletal pattern but a Class III dental relationship, an anterior and unilateral posterior open bite, a canted posterior occlusal plane, a clockwise rotation and vertical growth pattern of the mandible incorporating a chin deviation to the right.
Aim
The aim of treatment was to correct identified adverse oral habits, improve the facial profile and mandibular asymmetry, provide a satisfactory occlusion and restore TMJ health, which could not be guaranteed.
Methods
An occlusal splint was used in the first stage of treatment to intrude the posterior teeth, eliminate the occlusal disturbance and control the adverse oral habits. Two micro-implant anchorage devices were placed on the buccal and lingual sides of the left buccal segment to further intrude the left posterior teeth. MEAW technology was used after aligning and levelling the teeth.
Results
Satisfactory overbite, overjet and molar relationships were obtained and the facial profile greatly improved after orthodontic treatment, the outcome of which was stable at 24 months’ review.
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Affiliation(s)
- Jing Liao
- The State Key Laboratory of Oral Diseases and Department of Orthodontics , West China Hospital of Stomatology , Sichuan University , Chengdu , China
| | - Shushu He
- The State Key Laboratory of Oral Diseases and Department of Orthodontics , West China Hospital of Stomatology , Sichuan University , Chengdu , China
| | - Zhiai Hu
- The State Key Laboratory of Oral Diseases and Department of Orthodontics , West China Hospital of Stomatology , Sichuan University , Chengdu , China
| | - Shujuan Zou
- The State Key Laboratory of Oral Diseases and Department of Orthodontics , West China Hospital of Stomatology , Sichuan University , Chengdu , China
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Menezes LMD, Ritter DE, Locks A. Combining traditional techniques to correct anterior open bite and posterior crossbite. Am J Orthod Dentofacial Orthop 2013; 143:412-20. [PMID: 23452976 DOI: 10.1016/j.ajodo.2011.10.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 10/01/2011] [Accepted: 10/01/2011] [Indexed: 11/20/2022]
Abstract
The treatment of anterior open bite often requires the use of skeletal anchorage to prevent excessive eruption of the posterior teeth and consequent downward rotation of the mandible. However, this procedure might not always be accomplished. This article reports the successful treatment of an anterior open bite and a posterior crossbite in a young boy, combining traditional techniques and involving high-pull maxillary traction to help growth to correct the skeletal Class II malocclusion without skeletal anchorage. The vertical dentoalveolar contribution of maxillary growth was also favorable to close the bite, whereas cross-elastics corrected the axial inclination of the mandibular posterior teeth, eliminating the inverted posterior crossbite. The open bite was completely closed with edgewise appliances, which also achieved normal overjet, intercuspation, and incisor exposure on smiling. Traditional mechanics for the treatment of open bite and crossbite remain a useful alternative when patients do not accept skeletal anchorage.
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Affiliation(s)
- Luciane Macedo de Menezes
- Department of Orthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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22
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Espinar-Escalona E, Barrera-Mora JM, Llamas-Carreras JM, Ruiz-Navarro MB. The segmented arch approach: A method for orthodontic treatment of a severe Class III open-bite malocclusion. Am J Orthod Dentofacial Orthop 2013; 143:254-65. [PMID: 23374933 DOI: 10.1016/j.ajodo.2011.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/01/2011] [Accepted: 09/01/2011] [Indexed: 10/27/2022]
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23
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Fontes AM, Joondeph DR, Bloomquist DS, Greenlee GM, Wallen TR, Huang GJ. Long-term stability of anterior open-bite closure with bilateral sagittal split osteotomy. Am J Orthod Dentofacial Orthop 2012. [DOI: 10.1016/j.ajodo.2012.07.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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24
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Eight-year stability of a severe skeletal anterior open bite with a hyperdivergent growth pattern treated with an edgewise appliance and chin cup therapy. Am J Orthod Dentofacial Orthop 2012; 141:e65-74. [PMID: 22464537 DOI: 10.1016/j.ajodo.2011.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 07/01/2011] [Accepted: 07/01/2011] [Indexed: 11/21/2022]
Abstract
An adolescent boy with an Angle Class II Division 1 malocclusion had a hyperdivergent growth pattern with an excessive lower facial height and an anterior open bite. Combined orthodontic and surgical treatment should be considered for patients with a skeletal anterior open-bite malocclusion. For patients who do not want surgery, however, a 0.022 × 0.028-in nontorqued, nonangulated fixed appliance with a chincup as adjunct therapy is an alternative that can have excellent results. The final outcome of this treatment were great improvements in function, esthetics, and posttreatment stability after 8 years.
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Artese A, Drummond S, Nascimento JMD, Artese F. Critérios para o diagnóstico e tratamento estável da mordida aberta anterior. Dental Press J Orthod 2011. [DOI: 10.1590/s2176-94512011000300016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: dentre as más oclusões, a mordida aberta anterior é considerada uma das anomalias de mais difícil correção, sobretudo no que se refere à sua estabilidade. A literatura possui inúmeros trabalhos sobre o tema, porém com informações controversas e conflitantes. As discordâncias ocorrem desde a definição do que é a mordida aberta, passando por seus fatores etiológicos, até os possíveis tipos de tratamentos. Provavelmente, a falta de consenso sobre a etiologia da mordida aberta anterior originou tratamentos diversificados, o que pode explicar o alto índice de instabilidade pós-tratamento dessa má oclusão. OBJETIVO: rever os conceitos de etiologia, tratamento e estabilidade da mordida aberta anterior e apresentar critérios para o diagnóstico e tratamento dessa má oclusão, baseados em sua etiologia, e exemplificados por casos tratados e estáveis em longo prazo.
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