Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial.

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.

[1]  J. H. Parker The interception of the open bite in the early growth period. , 1971, The Angle orthodontist.

[2]  J. Fleiss,et al.  Confidence intervals vs significance tests: quantitative interpretation. , 1986, American journal of public health.

[3]  P. Davidson,et al.  Chronic thumb-sucking. A second report on treatment and its psychological effects. , 1970, American journal of orthodontics.

[4]  D. Moher,et al.  CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials , 2010, BMJ : British Medical Journal.

[5]  D. Bliss Thumb and finger sucking. , 1946, Oral health.

[6]  C. Flores‐Mir,et al.  Effectiveness of open bite correction when managing deleterious oral habits in growing children and adolescents: a systematic review and meta-analysis , 2017, European journal of orthodontics.

[7]  G. Janson,et al.  Treatment effects of bonded spurs associated with high-pull chincup therapy in the treatment of patients with anterior open bite. , 2012, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[8]  V. Kokich,et al.  Stability of anterior openbite treated with crib therapy. , 1990, The Angle orthodontist.

[9]  M. D. de Almeida,et al.  Dimensional changes of dental arches produced by fixed and removable palatal cribs: A prospective, randomized, controlled study. , 2017, The Angle orthodontist.

[10]  Nikolaos Pandis Randomization. Part 1: sequence generation. , 2011, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[11]  Ana Beatriz Chevitarese,et al.  Prevalence of malocclusion in 4-6 year old Brazilian children. , 2003, The Journal of clinical pediatric dentistry.

[12]  Martin Dewey,et al.  Classification of malocclusion , 1915 .

[13]  A. Gültan,et al.  Effects of vertical chincap therapy on the mandibular morphology in open-bite patients. , 2002, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[14]  Systematic review for orthodontic and orthopedic treatments for anterior open bite in the mixed dentition , 2016, Progress in orthodontics.

[15]  CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials , 2011, BMJ : British Medical Journal.

[16]  G. Janson,et al.  Anterior open-bite treatment with bonded vs conventional lingual spurs: A comparative study. , 2016, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[17]  A. L. Ramos,et al.  Effects of palatal crib and bonded spurs in early treatment of anterior open bite: A prospective randomized clinical study. , 2016, The Angle orthodontist.

[18]  R. R. Almeida-Pedrin,et al.  A prospective study of the treatment effects of a removable appliance with palatal crib combined with high-pull chincup therapy in anterior open-bite patients. , 2006, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[19]  T. Uğur,et al.  The effects of Frankel's function regulator (FR-4) therapy on the treatment of Angle Class I skeletal anterior open bite malocclusion. , 1995, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[20]  J. Jarabak Open bite , 1983, Fortschritte der Kieferorthopadie.

[21]  L. Franchi,et al.  Early orthodontic treatment of skeletal open-bite malocclusion: a systematic review. , 2005, The Angle orthodontist.

[22]  L. Franchi,et al.  Comparisons of two protocols for early treatment of anterior open bite , 2016, European journal of orthodontics.

[23]  N. Pandis The evidence pyramid and introduction to randomized controlled trials. , 2011, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[24]  C. Flores‐Mir,et al.  Dentoskeletal effects produced by removable palatal crib, bonded spurs, and chincup therapy in growing children with anterior open bite. , 2016, The Angle orthodontist.

[25]  J. McNamara,et al.  Treatment effects of a modified quad-helix in patients with dentoskeletal open bites. , 2006, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[26]  J. Henriques,et al.  Anterior open bite treated with a palatal crib and high-pull chin cup therapy. A prospective randomized study. , 2006, European journal of orthodontics.

[27]  W. Thomson,et al.  Factors influencing treatment time in orthodontic patients. , 2006, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.