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Marcílio Santos E, Kalil Bussadori S, Ratto Tempestini Horliana AC, Moraes Moriyama C, Jansiski Motta L, Pecoraro C, Cabrera Martimbianco AL. Functional orthopedic treatment for anterior open bite in children. A systematic review of randomized clinical trials. J Orofac Orthop 2023; 84:405-414. [PMID: 35438306 DOI: 10.1007/s00056-022-00388-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/06/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE This systematic review aimed to assess the effects of orthopedic functional appliances for anterior open bite (AOB) in primary or mixed dentition children. METHODS A search for randomized controlled trials (RCT) was conducted in November 2020 in electronic databases with no data or language restrictions. Primary outcomes were skeletal cephalometric variables and adverse events. We used the Cochrane risk-of-bias tool to assess methodological quality and the GRADE approach to assess the certainty of the evidence. RESULTS We identified five RCTs (220 participants). Very low certainty evidence showed an improvement in overbite (mean difference [MD] 3.60; 95% confidence interval [CI] 2.63-4.57) and in the angulation of the upper incisors to the palatal plane (MD 3.70; 95% CI 0.85-6.55) with Frankel's functional regulator, compared to no treatment. There was no difference in the measured cephalometric variables when comparing removable palatal crib to fixed palatal crib, bonded spurs, and chin cup. When comparing removable versus magnetic bite blocks, a beneficial effect was observed in overbite, overjet, skeletal anteroposterior angular measurements, and skeletal vertical linear measures in the magnetic group. No adverse events were reported. CONCLUSION There was insufficient evidence to infer the effects of these treatments for AOB, and high-quality RCTs are needed to increase the estimated effects. PROSPERO REGISTER CRD42020175634, prospectively registered (05 July 2020).
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Affiliation(s)
- Elaine Marcílio Santos
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Avenida Conselheiro Nébias, 536-Encruzilhada, 11045-002, Santos, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | | | | | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Carla Pecoraro
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Avenida Conselheiro Nébias, 536-Encruzilhada, 11045-002, Santos, SP, Brazil
| | - Ana Luiza Cabrera Martimbianco
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Avenida Conselheiro Nébias, 536-Encruzilhada, 11045-002, Santos, SP, Brazil.
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Scudine KGOD, de Moraes KN, Miyagui SA, Lamy E, Lopes MF, Mamani MH, Castelo PM. Understanding the relationship between orofacial structures and feeding habits of preschoolers: A multivariate analysis. J Texture Stud 2023; 54:470-480. [PMID: 36849700 DOI: 10.1111/jtxs.12748] [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: 07/04/2022] [Revised: 11/24/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
The understanding of the relationship between orofacial structures and feeding habits in preschoolers is helpful for health professionals and those dedicated to food science. The hypothesis tested was whether this relationship is already present even at a very young age. This cross-sectional study included 91 healthy caries-free children (50 girls/41 boys; 3.4-6.2 years; mean 4.1 years) and a comprehensive evaluation of the stomatognathic system was performed: dietary intake, facial and occlusal morphology, gustatory sensitivity, bite and lip forces, and orofacial myofunctional aspects (mastication, swallowing and breathing functions). Principal component analysis summarized the variables related to the form and function of the orofacial aspects; further, K-means analysis identified two clusters of participants with similar aspects. Cluster 1 ("Low orofacial myofunctional functioning"; n = 51) was characterized by children who showed the worst performance of mastication, swallowing and breathing functions and whose parents reported the consumption of sweets, cookies, chocolate, but not fresh fruits the day before, in addition to the higher bottle-feeding and pacifier use duration. This cluster also showed higher sweet taste threshold. Cluster 2 ("High orofacial myofunctional functioning"; n = 40) showed lower bottle-feeding and pacifier use duration, higher gustatory sensitivity, greater maxillo-mandibular dimensions, and better orofacial function performance. The variables sex and BMI did not associate to clusters profile. The frequencies of open bite and current sucking habit (pacifier) also differed between clusters. The results showed that an association between form and function of the structures that comprise the stomatognathic system and dietary intake is already present in children with primary dentition.
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Affiliation(s)
| | - Kizzy Nascimento de Moraes
- Department of Oral Rehabilitation, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
| | - Sania Aparecida Miyagui
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Elsa Lamy
- MED Mediterranean Institute for Agriculture, Environment and Development and CHANGE-Global Change and Sustainability Institute, Universidade de Évora, Évora, Portugal
| | - Mariana Fernandes Lopes
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Maribel Hilasaca Mamani
- Department of Pediatric Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Theodoridou MZ, Zarkadi AE, Zymperdikas VF, Papadopoulos MA. Long-term effectiveness of non-surgical open-bite treatment: a systematic review and meta-analysis. Prog Orthod 2023; 24:18. [PMID: 37258750 DOI: 10.1186/s40510-023-00467-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/31/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The etiology of open bite is complex, involving various genetic or environmental factors. Several treatment alternatives have been suggested for the correction of open bite, yet their long-term effectiveness remains controversial. OBJECTIVE To assess the long-term effectiveness of open-bite treatment in treated with non-surgical approaches versus untreated patients, through lateral cephalometric radiographs. SEARCH METHODS Unrestricted search of 16 electronic databases and manual searches up to November 2022. SELECTION CRITERIA Randomized or non-randomized controlled trials reporting on the long-term effects of open-bite treatment through angular lateral cephalometric variables. DATA COLLECTION AND ANALYSIS Only angular variables on lateral cephalometric radiographs were considered as primary outcomes. For each outcome, the mean differences and 95% confidence intervals were calculated using the random-effects model to consider existing heterogeneity. The revised Cochrane risk-of-bias tool (R.o.B. 2.0) and the risk-of-bias tool for non-randomized studies for interventions (ROBINS-I) were utilized for the randomized and non-randomized trials, respectively. RESULTS From the initially identified 26,527 hits, only 6 studies (1 randomized and 5 retrospective controlled trials) were finally included in this systematic review reporting on 244 open-bite individuals (134 patients and 110 untreated controls), while five of them were included in the meta-analyses, assessing either the interval ranging from treatment start to post-retention (T3-T1) or from end of treatment to post-retention period (T3-T2). Regarding the vertical plane, for the T3-T2 interval, no significant differences were found for the assessed skeletal measurements, indicating a relative stability of the treatment results. Similarly, with regard to the T3-T1 interval, no significant differences could be identified for the examined skeletal variables, implying that the produced effects are rather minimal and that the correction of the open bite was performed mainly through dentoalveolar rather than skeletal changes. Further, no significant changes could be identified regarding the inclination of the upper and lower incisors. Only the nasolabial angle was significantly reduced in the treated patients in the long term. CONCLUSIONS According to existing evidence, the influence of non-surgical treatment of open bite on the skeletal tissues and the inclination of the incisors is rather minimal in the long term, while only the nasolabial angle was significantly reduced.
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Affiliation(s)
- Maria-Zoi Theodoridou
- Department of Public Health, Faculty of Medicine, European University of Cyprus, Nicosia, Cyprus
| | - Athanasia-Eirini Zarkadi
- Department of Paediatric Dentistry, School of Dentistry, Scholl of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios F Zymperdikas
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Dental Department, 424 Military Hospital of Thessaloniki, Thessaloniki, Greece.
- Department of Midwifery, School of Health Sciences, University of Western Macedonia, Ptolemaida, Greece.
| | - Moschos A Papadopoulos
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Meng M, Xie Y, Cao J, Yu Y, Zhou X, Zou J. Effects of bonded spurs, fixed and removable palatal crib in the early treatment of anterior open bite: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 163:298-310. [PMID: 36564317 DOI: 10.1016/j.ajodo.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by different authors. This meta-analysis aimed to evaluate the effect of bonded spurs, fixed and removable palatal cribs in the early treatment of AOB. METHODS A comprehensive electronic search was carried out through PubMed, Embase (via Ovid), MEDLINE (via Ovid), Cochrane Central Register of Controlled Trials, and Web of Science up to May 1, 2022. This meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The work was carried out by 2 reviewers in duplicate and independently, including electronic searching, data extracting, risk of bias assessment, quality of evidence grading, heterogeneity and statistical power analysis, and eligibility evaluation of the retrieved articles. RESULTS Four studies out of 181 articles were recruited in the meta-analysis after applying the inclusion and exclusion criteria. The results showed that bonded lingual spurs and fixed palatal crib or spurs produced similar overbite changes (mean difference, -0.32; 95% confidence interval, -1.06 to 0.43; P = 0.41; I2 = 27%; meta power = 0.099). Fixed palatal crib and removable palatal crib also exhibited comparable effects in correcting AOB (mean difference, -0.02; 95% confidence interval, -0.90 to 0.86; P = 0.96; I2 = 0%; meta power = 0.2182). The quality of evidence about these 2 outcomes assessed with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was low. CONCLUSIONS Bonded lingual spurs, fixed palatal crib or spurs, and removable palatal crib had similar effects in the early treatment of AOB. Because the number of included studies was limited and only the overbite changes before and after treatment were assessed, more clinical randomized controlled studies with longer follow-ups are needed to get more clinically significant advice.
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Affiliation(s)
- Mingmei Meng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yongting Xie
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingwei Cao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Yu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Jing Zou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Moda LB, Ribeiro SMM, Chaves Junior SDC, Artese F, Normando D. Can lingual spurs alter the oral health-related quality of life during anterior open bite interceptive treatment? A systematic review. Dental Press J Orthod 2023; 28:e2321298. [PMID: 37075416 PMCID: PMC10108583 DOI: 10.1590/2177-6709.28.1.e2321298.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/05/2022] [Indexed: 04/21/2023] Open
Abstract
INTRODUCTION The use of lingual spurs has been described as one efficient option, with great stability of results, but with scarce information of toleration for use in the mixed and permanent dentition phases. OBJECTIVE The purpose of this study was to assess the impact of lingual spurs on the oral health-related quality of life of children and/or adolescents during anterior open bite treatment. METHODS The review was recorded in the PROSPERO database. Eight electronic databases and partial gray literature were searched, without restrictions until march 2022. A manual search was also performed in the references of the included articles. Studies assessing the impact of lingual spurs on the oral health-related quality of life were included. Risk of bias was assessed using JBI or ROBINS-I tool, according to the study design. The level of evidence was assessed through GRADE. RESULTS Five studies met the eligibility criteria. Two non-randomized clinical trials had a serious risk of bias. Of the case-series studies, two had a low risk of bias and the other, a moderate risk of bias. The certainty of the evidence was classified as very low for all the evaluated results. In general, the studies reported an initial negative impact with the use of lingual spurs, however this was transitory in nature. A quantitative analysis was not performed due to the great heterogeneity between the studies. CONCLUSION Current evidence, although limited, suggests that lingual spurs have an initial transient negative impact during interceptive treatment. Additional well-conducted randomized clinical trials are needed.
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Affiliation(s)
- Larissa Barbosa Moda
- Department of Orthodontics, Dental School, Federal University of Pará (UFPA, Belém, Pará, Brazil)
| | | | | | - Flavia Artese
- Department of Orthodontics, Dental School, Rio de Janeiro State University (UERJ, Rio de Janeiro, Brazil)
| | - David Normando
- Department of Orthodontics, Dental School, Federal University of Pará (UFPA, Belém, Pará, Brazil)
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Three-dimensional dentoalveolar changes in open bite treatment in mixed dentition, spurs/posterior build-ups versus spurs alone: 1-year follow-up randomized clinical trial. Sci Rep 2022; 12:12378. [PMID: 35858941 PMCID: PMC9300740 DOI: 10.1038/s41598-022-15988-9] [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: 12/26/2021] [Accepted: 07/04/2022] [Indexed: 11/12/2022] Open
Abstract
This randomized clinical trial aimed to compare the three-dimensional dentoalveolar maxillary changes after anterior open bite treatment with bonded spurs and build-ups versus bonded spurs alone. Patients from 7 to 11 years of age with anterior open bite were randomly allocated into two groups. Bonded spurs and posterior build-ups were used in the experimental group and only bonded spurs were used in the comparison group. The randomization sequence was generated at www.randomization.com. Opaque, sealed and sequentially numbered envelopes were part of the allocation concealment. Digital dental models were acquired before (T1) and after 12 months of treatment (T2) and de-identified for analysis purposes. Three-dimensional changes of maxillary permanent incisors and first molars were evaluated by means of T1 and T2 dental model superimposition. Landmark-based registration on the posterior teeth and registration on the palate using regions of interest were performed. T or Mann–Whitney U tests were used for intergroup comparisons (P < 0.05). Mean difference (MD) and 95% confidence interval (CI) were calculated. Twenty-four children (17 girls and 7 boys) were included in the experimental group (mean age 8.22 ± 1.06 years) and 25 children (14 girls and 11 boys) were included in the comparison group (mean age 8.30 ± 0.99 years). After 12 months of treatment, inferior displacements of maxillary incisors were similar in the experimental (1.55–2.92 mm) and comparison (1.40–2.65 mm) groups. Inferior displacement of the maxillary molars was also similar in both groups (MD: − 0.13 mm; 95% CI − 0.38, 0.12). The experimental and comparison groups showed medial and lateral displacements of the permanent first molars, respectively (MD, − 0.31 mm; 95% CI − 0.51, − 0.11). Lingual inclination of the permanent first molars were observed in the experimental group and buccal inclination in the comparison group (MD, − 2.16°; 95% CI − 3.72, − 0.60). Similar three-dimensional displacements of maxillary central and lateral incisors, and inferior displacements of maxillary permanent first molars were observed in both groups. Bonded spurs associated with posterior build-ups demonstrated some medial displacement and lingual inclination of the maxillary permanent first molars while opposite changes were noticed in the comparison group. Trial registration: Clinicaltrials.gov; NCT03702881, date of registration: October 11, 2018.
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Fouda AS, Afify AK, Aboulfotouh MH, Attia KH, Abouelezz AM, Elkordy SA. Dental arch changes after anterior open bite treatment in the mixed dentition produced by miniscrew-supported palatal crib vs conventional fixed palatal crib. Angle Orthod 2022; 92:487-496. [PMID: 35130348 DOI: 10.2319/082321-659.1] [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: 08/01/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the dental arch changes produced by the miniscrew-supported palatal crib (MSPC) and the conventional fixed palatal crib (CFPC) after the treatment of patients with anterior open bite (AOB) attributed to the tongue-thrusting habit in the mixed dentition stage. MATERIALS AND METHODS A total of 26 children aged 8 to 11 years with an AOB were randomly distributed into two equal groups; the MSPC group was treated using a palatal crib supported by two miniscrews inserted paramedially, whereas the CFPC group was treated using a conventional fixed palatal crib soldered to bands. Digital models were obtained pretreatment and after a follow-up duration of 9 months. RESULTS The MSPC group included 12 participants (9 girls and 3 boys; mean age, 9.4 ± 0.75 years), and the CFPC group included 12 participants (10 girls and 2 boys; mean age, 9.0 ± 0.73 years). The amount of AOB closure was similar in both groups: 3.97 ± 1.44 mm in the MSPC group and 3.97 ± 0.89 mm in the CFPC group. There was significant mesial movement of the maxillary first molar in the CFPC (-1.42 ± 0.99 mm) compared with the MSPC group (-0.53 ± 0.32 mm). CONCLUSIONS Both appliances resulted in similar improvement in the amount of AOB closure. There was significantly more mesial movement of the maxillary first molars in the CFPC group compared with the MSPC group.
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Pegoraro NDA, dos Santos CM, Colvara BC, Rech RS, Faustino-Silva DD, Hugo FN, Hilgert JB. Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil. Codas 2021; 34:e20210007. [PMID: 34816947 PMCID: PMC9769416 DOI: 10.1590/2317-1782/20212021007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/26/2021] [Indexed: 08/22/2023] Open
Abstract
PURPOSE to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. METHODS a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. RESULTS out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). CONCLUSION the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.
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Affiliation(s)
| | | | | | - Rafaela Soares Rech
- Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil
| | - Daniel Demétrio Faustino-Silva
- Programa de Pós-Graduação em Avaliação de Tecnologias para o SUS, Grupo Hospitalar Conceição – GHC - Porto Alegre (RS), Brasil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul – UFRGS - Porto Alegre (RS), Brasil
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Dias FA, Oltramari PVP, Almeida MRD, Conti ACDCF, Almeida RRD, Fernandes TMF. Stability of early anterior open bite treatment: a 2-year follow-up randomized clinical trial. Braz Dent J 2021; 32:116-126. [PMID: 34755786 DOI: 10.1590/0103-6440202103509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.
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Aliaga-Del Castillo A, Vilanova L, Janson G, Arriola-Guillén LE, Garib D, Miranda F, Massaro C, Yatabe M, Cevidanes L, Ruellas AC. Comparison and reproducibility of three methods for maxillary digital dental model registration in open bite patients. Orthod Craniofac Res 2021; 25:269-279. [PMID: 34543518 DOI: 10.1111/ocr.12535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/26/2021] [Accepted: 09/13/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare and assess the reproducibility of 3 methods for registration of maxillary digital dental models in patients with anterior open bite. Settings and sample population Digital dental models of 16 children with an anterior open bite in the mixed dentition were obtained before (T1) and after 12 months of treatment with bonded spurs (T2). METHODS Landmarks were placed on all T2 models and 3 registration methods (R1, R2 and R3) were independently performed by 2 observers. R1 was based on 10 landmarks placed on posterior teeth. R2 was based on 5 landmarks on the palate (2 anterior, 2 posterior and 1 central). R3 used regions of interest around the 5 palatal landmarks used in R2. The differences between the registration methods were calculated by comparing the mean differences and standard deviations between the corresponding x, y and z coordinates of 6 corresponding landmarks in the T2 registered models. Repeated measures analysis of variance followed by post-hoc Bonferroni tests were used for comparisons (P < .05). The agreement between methods and the intra and interobserver reproducibility were assessed with Bland-Altman tests and intraclass correlation coefficients (ICC). RESULTS Comparisons of R2 with R3 methods showed greater agreement, mean differences ≤0.50 mm for all landmarks, than comparisons of R1 with R2, and R1 with R3, mean differences >0.50 mm for most of the y and z coordinates (P < .05). The R1 and R3 methods presented excellent intra and interobserver reproducibility and R2 method had moderate interobserver reproducibility. CONCLUSIONS Longitudinal assessments of open bite treatment using digital dental models could consider the posterior teeth and/or the palate as references. The R1 and R3 methods showed adequate reproducibility and yield different quantitative results. The choice will depend on the posterior teeth changes and dental models' characteristics.
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Affiliation(s)
| | - Lorena Vilanova
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | - Guilherme Janson
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Daniela Garib
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil.,Department of Orthodontics, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil
| | - Felicia Miranda
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | - Camila Massaro
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Antonio Carlos Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Mousa MR, Hajeer MY, Farah H. Evaluation of the open-bite Bionator versus the removable posterior bite plane with a tongue crib in the early treatment of skeletal anterior open bite: A randomized controlled trial. J World Fed Orthod 2021; 10:163-171. [PMID: 34462242 DOI: 10.1016/j.ejwf.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/01/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Several treatment approaches can be found in the literature about early treatment of open bite. However, no studies have addressed the use of a removable posterior bite plane with a tongue crib (RPBP/C), compared with functional appliances, for treating open-bite cases. The objectives of this trial was to compare the effectiveness of the open-bite Bionator (OBB) and the RPBP/C as an early intervention to correct skeletal open-bite cases in children, in terms of limiting excessive vertical growth of the craniofacial skeletal components and normalizing the developement of the anterior dentoalveolar region. MATERIALS AND METHODS Two-arm, parallel-group randomized controlled trial was conducted. Forty patients with a skeletal anterior open bite (age range: 7.5-10.5 years) were treated at the University of xxxx School of Dentistry in xxxx, xxxx. They were distributed randomly into 2 equal groups: the OBB group (20 patients; mean age: 8.8 ± 1.5 years) and the RPBP/C group (20 patients; mean age: 8.6 ± 1.1 years). Randomization was based on a computer-generated sequence of random numbers. Primary outcome measures were the skeletal and dentoalveolar variables, whereas the secondary outcome measures were the soft-tissue parameters assessed on standardized lateral cephalograms collected before and after 12 months of treatment. Mann-Whitney U tests were used to detect significant differences between the 2 groups. RESULTS Both the OBB and the RPBP/C appliances induced favorable dental effects. A statistically significant difference was found between the 2 groups in the overbite (P = 0.003). Open bite in the OBB group showed a mean closure of 4.91 mm (SD 0.4 mm), and a mean closure of 3.43 mm (SD 0.3 mm) was observed in the RPBP/C group. Dentoalveolar changes at the anterior region were evident, with statistically significant extrusion, and lingual tipping of the maxillary and mandibular incisors (P ≤ 0.05). The results showed no significant differences in the skeletal changes between the 2 groups. CONCLUSIONS The OBB and the upper posterior bite plane with crib were both effective in the early treatment of the skeletal anterior open bite. However, closure of the anterior open bite was mainly due to the dentoalveolar changes at the anterior region of the dental arches.
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Affiliation(s)
- Mahran Raheel Mousa
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria.
| | - Hassan Farah
- University of Hama, Head of the Orthodontic Department, School of Dentistry, Hama, Syria
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Rossato PH, Bayer LB, Almeida RRD, Conti ACDCF, Fernandes TMF, Oltramari PVP. Clinical complications during early treatment of anterior open bite. Braz Oral Res 2021; 35:e081. [PMID: 34231768 DOI: 10.1590/1807-3107bor-2021.vol35.0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022] Open
Abstract
The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.
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Affiliation(s)
- Paulo Henrique Rossato
- Universidade Norte do Paraná - Unopar, School of Dentistry, Department of Orthodontics, Londrina, PR, Brazil
| | - Letícia Batista Bayer
- Universidade Norte do Paraná - Unopar, School of Dentistry, Department of Orthodontics, Londrina, PR, Brazil
| | - Renato Rodrigues de Almeida
- Universidade Norte do Paraná - Unopar, School of Dentistry, Department of Orthodontics, Londrina, PR, Brazil
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Mohamed M, Ferguson DJ, Venugopal A, Alam MK, Makki L, Vaid NR. An artificial intelligence based referral application to optimize orthodontic referrals in a public oral healthcare system. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Aliaga-Del Castillo A, Bellini-Pereira SA, Vilanova L, Miranda F, Massaro C, Arriola-Guillén LE, Garib D, Janson G. Dental arch changes after open bite treatment with spurs associated with posterior build-ups in the mixed dentition: A randomized clinical trial. Am J Orthod Dentofacial Orthop 2021; 159:714-723.e1. [PMID: 33795189 DOI: 10.1016/j.ajodo.2020.11.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION This single-center, 2-arm, parallel-group randomized clinical trial aimed to compare the dimensional dental arch changes after anterior open bite (AOB) treatment with bonded spurs associated with posterior build-ups vs bonded spurs alone. METHODS Patients aged between 7 and 11 years with AOB were recruited at a university clinic and randomly allocated into 2 groups. The experimental group was treated with bonded spurs associated with posterior build-ups (SBU) and the comparison group with bonded spurs alone (S). Digital dental models were obtained at pretreatment and after 12 months of treatment. The overbite change was the primary outcome. The randomization list was obtained at the Web site www.randomization.com. Allocation concealment involved sequentially numbered, sealed, and opaque envelopes. The outcomes' assessment was blinded. Analysis of covariance was used for intergroup comparisons (P <0.05). Mean difference (MD) and 95% confidence interval (CI) were obtained. RESULTS Twenty-four patients (mean age, 8.22 ± 1.06 years; 7 males and 17 females) were included in the SBU group, and 25 patients (mean age, 8.30 ± 0.99 years; 11 males and 14 females) were included in the comparison group. After a 12-month follow-up, the overbite increased approximately 4 mm in both groups (MD, -0.11 mm; 95% CI, -1.03 to 0.80). Means of anterior dentoalveolar vertical development ranged from 2.24 mm (S group) to 2.49 mm (SBU group) and from 1.31 mm (SBU group) to 1.55 mm (S group) for the maxilla (MD, -0.24 mm; 95% CI, -0.91 to 0.44) and mandible (MD, 0.29 mm; 95% CI, -0.39 to 0.96), respectively. The maxillary intermolar distance decreased in the SBU group and increased in the S group (MD, -0.48 mm; 95% CI, -0.92 to -0.03). The mandibular intermolar distance increased in the SBU group and decreased in the comparison group (MD, 0.26 mm; 95% CI, 0.004-0.52). Plaque accumulation around the spurs was observed in some patients. CONCLUSIONS Both protocols demonstrated similar improvements in the AOB with similar effects on the dental arches. The SBU group showed a slight decrease in the maxillary intermolar distance and a slight increase in the mandibular intermolar distance, whereas opposite changes were observed for the S group. REGISTRATION This trial was registered at Clinicaltrials.gov (Identifier NCT03702881). PROTOCOL The study protocol was not published. FUNDING This work was supported by the São Paulo Research Foundation (FAPESP) grants nos. 2017/06440-3, 2018/05238-9, and 2018/24003-2; and financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES), Finance Code 001.
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Affiliation(s)
| | | | - Lorena Vilanova
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School, and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
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Justulin AF, Rossato PH, Conti ACCF, Almeida MR, Pedron Oltramari PV, Fernandes TMF. Relapse of Anterior Open Bite: A Case Report. Int J Clin Pediatr Dent 2021; 14:140-144. [PMID: 34326600 PMCID: PMC8311762 DOI: 10.5005/jp-journals-10005-1893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim and objective of this study is to report the recurrence of the treatment of the anterior open bite after 5 years of treatment. A female patient aged 8 years 6 months old had a negative vertical crossing of -4.7 mm. Early treatment with a fixed palatal grid was performed for 1 year. At the end of the treatment, the vertical overpass was 1.1 mm and after 2 years of control, the vertical overpass remained positive with 1.7 mm showing the stability of the treatment. After 5 years, and due to the sucking and lingual interposition habit, there was a recurrence of the open bite. Interdisciplinary follow-up is extremely important to eliminate the factors responsible for the origin of deleterious habits, thus solving the changes resulting from these habits and providing long-term stability. How to cite this article: Justulin AF, Rossato PH, Conti ACCF, et al. Relapse of Anterior Open Bite: A Case Report. Int J Clin Pediatr Dent 2021;14(1):140-144.
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Affiliation(s)
- Aline F Justulin
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | - Paulo H Rossato
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | - Ana CCF Conti
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | - Marcio R Almeida
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | | | - Thais MF Fernandes
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
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Aliaga-Del Castillo A, Vilanova L, Miranda F, Arriola-Guillén LE, Garib D, Janson G. Dentoskeletal changes in open bite treatment using spurs and posterior build-ups: A randomized clinical trial. Am J Orthod Dentofacial Orthop 2020; 159:10-20. [PMID: 33221096 DOI: 10.1016/j.ajodo.2020.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/01/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION This single-center 2-arm parallel randomized clinical trial aimed to compare the dentoskeletal effects of bonded spurs combined with posterior build-ups vs conventional bonded spurs in the treatment of anterior open bite malocclusion in the mixed dentition. METHODS Patients aged from 7 to 11 years with anterior open bite, recruited at a university orthodontic clinic, were randomly allocated into 2 groups. The experimental group consisted of patients treated with bonded spurs combined with posterior build-ups. The comparison group comprised patients treated with conventional bonded spurs. Lateral headfilms were obtained at pretreatment and after 12 months of treatment. The primary outcome was the change in the overbite. Randomization was performed using the Web site www.randomization.com. Sequentially numbered opaque and sealed envelopes were used for allocation concealment. Blinding was applicable for outcome assessment only. Intergroup comparisons were performed using t or Mann-Whitney U tests (P <0.05). Mean difference (MD) and 95% confidence interval (CI) were obtained. RESULTS The experimental group included 24 patients (17 female, 7 male; mean age, 8.22 ± 1.06 years) and the comparison group comprised 25 patients (14 female, 11 male; mean age, 8.30 ± 0.99 years). Baseline demographic and cephalometric characteristics were similar between groups. After 12 months, all patients showed improvements. Both groups showed similar improvements of the overbite (MD, 0.00 mm; 95% CI, -0.92 to 0.91), similar slight decreases of the gonial (MD, 0.02°; 95% CI, -1.11 to 1.15) and mandibular plane (MD, 0.15°; 95% CI, -0.64 to 0.93) angles, and similar mandibular molar extrusion (MD, 0.14 mm; 95% CI, -0.27 to 0.56). The experimental group showed significantly smaller extrusion of the maxillary first molar than the comparison group (MD, -0.70 mm; 95% CI, -0.92 to -0.49). The other dentoskeletal variables showed similar changes without statistically significant intergroup differences. No serious harm was observed other than plaque accumulation around the spurs. CONCLUSIONS Similar overbite increases and dentoskeletal changes were observed in both groups after 12 months of treatment. Although the experimental group showed significantly smaller extrusion of the maxillary molars, no greater counterclockwise rotation of the mandible than the comparison group was observed. REGISTRATION This trial was registered at Clinicaltrials.gov (Identifier NCT03702881). PROTOCOL The protocol was not published. FUNDING This trial was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES), Finance Code 001; and by grants: no. 2017/06440-3, no. 2018/05238-9 and no. 2018/24003-2, São Paulo Research Foundation (FAPESP).
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Affiliation(s)
| | - Lorena Vilanova
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School, and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
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Comparison Between Removable and Fixed Devices for Nonskeletal Anterior Crossbite Correction in Children and Adolescents: A Systematic Review. J Evid Based Dent Pract 2020; 20:101423. [PMID: 32921377 DOI: 10.1016/j.jebdp.2020.101423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/26/2019] [Accepted: 01/17/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare removable and fixed orthodontic devices in the correction of non-skeletal anterior crossbite in children and adolescents in the mixed dentition. MATERIALS AND METHODS Electronic searches were conducted in the following databases: PubMed, Web of Science, Scopus, Medline Ovid, Lilacs, US Clinical Trials, and Proquest. A hand search of the reference lists of the included articles and a Google Scholar search were also conducted. References were evaluated by 2 review authors. Articles that met the eligibility criteria were included. Data extraction, methodological quality assessment (Cochrane tool), and strength of the evidence evaluation (GRADE) were also carried out. RESULTS Seven articles were included. The results showed that removable and fixed devices were equally efficacious for overjet correction. Removable and fixed devices can also present inconveniences regarding pain and discomfort levels, the accomplishment of everyday activities (leisure and school), and the performance of functions, such as chewing and speech. However, treatment time and costs were significantly lower in orthodontic therapy with fixed appliances. Sequence generation, allocation concealment, and complete outcome data were not a concern. Blinding of participants or personnel was not reported in any article, and blinding of the assessor was a concern in 2 articles. Selective reporting was a concern in 2 articles. The certainty of the evidence for overjet correction was very low. CONCLUSION Removable and fixed orthodontic devices are efficacious for overjet correction in non-skeletal anterior crossbite. However, treatment time and costs are lower for cases treated with fixed devices.
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Rossato PH, Fernandes TMF, Urnau FDA, de Castro AC, Conti F, de Almeida RR, Oltramari-Navarro PVP. Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial. Angle Orthod 2018; 88:684-691. [PMID: 29911909 DOI: 10.2319/101317-691.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES: To compare different appliances for early anterior open bite (AOB) correction. MATERIALS AND METHODS: This was a parallel, randomized clinical trial. A prospective sample of patients with AOB was recruited consecutively. Eligibility criteria included angle class I malocclusion with AOB equal to or greater than 1 mm. Participants were allocated by simple randomization to 4 groups: bonded spurs, chin cup, fixed palatal crib, and removable palatal crib. Dentoalveolar changes among the groups were assessed by blinded observers by comparing lateral cephalograms taken before (T1) and 12 months after treatment (T2; analysis of variance followed by Tukey test). Of the measurements, 30% were reassessed for reliability (intraclass correlation coefficient and Bland-Altman agreement test; α = 5%; 95% confidence interval). RESULTS: A total of 99 patients with a mean AOB of 3.7 mm (mean age 8.4 ± 0.8 years, both genders) were recruited. Dropouts occurred in all the groups, yielding a final sample size of 81 analyzed individuals. Intergroup comparisons of differences (T2-T1) showed significant differences for the incisor positioning variables (1.1, 1-PP, 6-PP, IMPA, 1.NB and 1-GoMe). However, there was no significant difference in AOB reduction among the groups, with an average correction of 3.1 mm. CONCLUSIONS: All of the tested devices promoted dental changes, especially in the anterior region, and contributed to AOB reduction during the study period. However, fixed palatal crib demonstrated greater impact on the positioning of the incisors.
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Cassis MA, de Almeida RR, Janson G, Aliaga-Del Castillo A, de Almeida MR. Stability of anterior open bite treatment with bonded spurs associated with high-pull chincup. Orthod Craniofac Res 2018. [PMID: 29537699 DOI: 10.1111/ocr.12223] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the stability of anterior open bite (AOB) treatment with bonded spurs associated with high-pull chincup (BS/HPCC). METHODS The experimental group consisted of 25 Class I AOB patients (15 female, 10 male) treated with BS/HPCC for 1 year. Cephalograms were analysed at pre-treatment (T1), post-treatment (T2) and at the 3-year post-treatment (T3) stage with the patients mean ages of 8.10, 9.14 and 12.18 years, respectively. The control group consisted of 23 subjects (13 female, 10 male) with normal occlusion, with comparable ages at the 3 stages (8.45, 9.45 and 12.50 years at T1, T2 and T3, respectively). T tests were used for intergroup comparisons at T1 and to compare the changes during the 3-year post-treatment period (T2-T3). Intragroup comparison in the treated group was evaluated with dependent t tests between T1 and T2. Correlations between the overbite changes in the T2-T3 period, the pre-treatment AOB severity and the amount of correction achieved during treatment were evaluated with Pearson's correlation coefficient. RESULTS No statistically significant relapse of the AOB was found at T3. Only 1 patient had a clinically significant AOB relapse. Neither the pre-treatment AOB severity nor the amount of correction was related to overbite changes during the 3-year post-treatment period. CONCLUSIONS There was no statistically significant relapse of the AOB, and the clinical stability of AOB correction 3-year post-treatment was of 96%.
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Affiliation(s)
- M A Cassis
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - R R de Almeida
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.,Department of Orthodontics, University of North Paraná, UNOPAR, Londrina, Brazil
| | - G Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - A Aliaga-Del Castillo
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - M R de Almeida
- Department of Orthodontics, University of North Paraná, UNOPAR, Londrina, Brazil
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Correction of Malocclusion by Botulinum Neurotoxin Injection into Masticatory Muscles. Toxins (Basel) 2018; 10:toxins10010027. [PMID: 29301317 PMCID: PMC5793114 DOI: 10.3390/toxins10010027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 12/17/2022] Open
Abstract
Botulinum toxin (BTX) is a neurotoxin, and its injection in masticatory muscles induces muscle weakness and paralysis. This paralytic effect of BTX induces growth retardation of the maxillofacial bones, changes in dental eruption and occlusion state, and facial asymmetry. Using masticatory muscle paralysis and its effect via BTX, BTX can be used for the correction of malocclusion after orthognathic surgery and mandible fracture. The paralysis of specific masticatory muscles by BTX injection reduces the tensional force to the mandible and prevents relapse and changes in dental occlusion. BTX injection in the anterior belly of digastric and mylohyoid muscle prevents the open-bite and deep bite of dental occlusion and contributes to mandible stability after orthognathic surgery. The effect of BTX injection in masticatory muscles for maxillofacial bone growth and dental occlusion is reviewed in this article. The clinical application of BTX is also discussed for the correction of dental malocclusion and suppression of post-operative relapse after mandibular surgery.
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Mucedero M, Vitale M, Franchi L, Cozza P, Perillo L. Comparisons of two protocols for early treatment of anterior open bite. Eur J Orthod 2017; 39:270-276. [PMID: 27141934 DOI: 10.1093/ejo/cjw039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aim The purpose of this study was to compare the outcomes of the treatment with the quad-helix/crib (Q-H/C) appliance with those of a combination of transpalatal arch, high-pull headgear, and lip bumper (TPA/HG/LB) in growing patients with anterior open bite malocclusion. Methods The TPA/HG/LB sample consisted of 22 subjects, 16 girls and 6 boys (mean age 7.5±1.4 years at the start of treatment, T1, and 8.7±1.5 years at the end of active treatment, T2). The Q-H/C sample consisted of 28 subjects, 17 girls and 11 boys (mean age 8.2±1.3 years at T1, and 8.7±1.6 years at T2). Both treated groups were compared with a control group of 20 untreated subjects matched for dentoskeletal disharmony and observation interval. The changes from T2 to T1 between the three groups were compared with the analysis of variance. Results Both TPA/HG/LB and Q-H/C groups exhibited greater reduction of the palatal plane to mandibular plane angle (-1.7° and -1.9°, respectively) and a significantly greater increase in overbite (2.2 and 2.3mm, respectively) with respect to controls. Conclusions Q-H/C and TPA/HG/LB protocols were equally effective in correcting the anterior open bite.
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Affiliation(s)
- Manuela Mucedero
- Department of Orthodontics, Università degli Studi di Roma Tor Vergata, Roma
| | | | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, Università degli Studi di Firenze, Firenze, Italy
| | - Paola Cozza
- Department of Orthodontics, Università degli Studi di Roma Tor Vergata, Roma.,Department of Orthodontics, School of Dentistry, University Nostra Signora del Buon Consiglio, Tirana, Albania
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Littlewood SJ. [Retaining corrected skeletal open bites. How can we increase the stability of our results?]. Orthod Fr 2016; 87:457-465. [PMID: 27938657 DOI: 10.1051/orthodfr/2016045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Retaining corrected skeletal anterior open bites is challenging. If it is possible to identify the aetiological factors causing an open bite, an appropriate choice of treatment and retention may reduce relapse. Extruding anterior teeth to close anterior open bites is known to be unstable, so treatment is typically aimed at controlling the vertical position of maxillary molars, in addition to removing causative factors, such as breaking habits and improving tongue posture. Relapse rates are high, with relapse estimated at about 20-30%, with slightly more stability for a surgical approach. MATERIALS AND METHODS Various approaches with retainers are described that aim to restrict the eruption of posterior teeth, and improve the position of the tongue. RESULTS These retainers often require excellent patient compliance and there is a lack of high quality evidence to support their use. Further research is required to confirm the effectiveness of these approaches.
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Slaviero T, Fernandes TMF, Oltramari-Navarro PVP, de Castro AC, Conti F, Poleti ML, de Almeida MR. Dimensional changes of dental arches produced by fixed and removable palatal cribs: A prospective, randomized, controlled study. Angle Orthod 2016; 87:215-222. [PMID: 27598906 DOI: 10.2319/060116-438.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the dimensional changes of dental arches on digital models of open bite treatment with fixed and removable palatal cribs. MATERIALS AND METHODS The sample comprised 41 patients of both sexes who were white, aged 7-10 years, and who had mixed dentition, Angle Class I molar relationship, and a negative overbite of at least 1 mm. The sample was randomly divided into two groups: G1, fixed palatal crib; and G2, removable palatal crib. Cast models, obtained initially (T1) and after 1 year of treatment (T2), were scanned by a three-dimensional (3D) scanner, 3Shape R700, producing a 3D image. Measurements were performed by a calibrated examiner using OrthoAnalyzer™ 3D software. RESULTS At T2-T1, differences were observed between the groups regarding vertical dentoalveolar development and overjet. There was more mandibular incisor extrusion for G1 (-1.66 mm) than for G2 (-0.54 mm). An overjet increase was observed in G1 (0.56 mm), in contrast to a reduction in G2 (-0.40 mm). There was a similar overbite increase for both groups (3.51 mm for fixed palatal crib and 3.88 mm for removable palatal crib). CONCLUSIONS Both the treatment protocols are similarly effective for anterior open bite correction, providing an overbite increase with dentoalveolar arch changes, especially in the anterior region.
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