Cephalometric comparison of adult anterior open bite treatment using clear aligners and fixed appliances

Abstract

Objectives: To compare fixed appliances and clear aligner therapy in correcting anterior open bite and in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns. Materials and Methods: In this retrospective study, two treatment groups of adult (≥18 years old) hyperdivergent patients (mandibular plane angles of ≥38°) with anterior open bites were included: 17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurements representing the vertical dimension were reported for each group. A two-sample t-test was used to assess differences in changes in mandibular plane angle and overbite between the two treatment groups. Results: There were no statistical differences found in the magnitude of overbite correction and the changes in any of the cephalometric measurements for vertical control. The clear aligner group showed a slightly greater amount of lower incisor extrusion (P = .009). The main mechanism of open bite correction was similar between the two treatment groups and was accomplished through retroclination of the upper and lower incisors while maintaining the vertical position of the upper and lower molars. Conclusions: Cephalometric comparison of anterior open bite correction and changes in the mandibular plane angle associated with use of clear aligners and fixed appliances did not demonstrate statistically significant differences in adult hyperdivergent patients.

Evaluation of open bite closure using clear aligners: a retrospective study

“…The average initial open bite for our patients at T0 was – 1.21 ± 1.15 mm. This pre-treatment severity was similar to the study by Khosravi et al [ 6 ] which had an initial open bite of – 1.1 mm, but less than those described by Moshiri et al [ 7 ] and Garnett et al [ 8 ]. Our results show that the average overbite change during treatment was 3.27 ± 1.09 mm.…”

“…The fixed appliance group included patients treated with extractions and TADs (Temporary Anchorage Devices), while the clear aligner group did not. The results did not show any significant differences in the treatment outcomes between the groups, suggesting that clear aligners might have the same efficacy at controlling the vertical dimension as fixed appliances with additional auxiliaries, such as TADs in hyperdivergent patients [ 8 ]. Based on this limited evidence, additional research is needed to better clarify the mechanism by which aligners are primarily used in open bite correction.…”

MicroCT X-ray comparison of aligner gap and thickness of six brands of aligners: an in-vitro study

“…As regards the analysis of single movements, the literature agrees that rotation of cone-shaped teeth [4] and movements that require good root control [6] are those most difficult to obtain with aligners, while crown tipping and intrusion are the most predictable [7][8][9]. In contrast, the literature contains differing reports on the efficacy of aligners in achieving extrusion [10]. That being said, it is generally agreed that aligners are particularly efficient at resolving malocclusions of slight to moderate complexity in non-extraction cases due to their good capacity to expand, align and level the arches [5,11].…”

The Use of High Frequency Vibration and Clear Aligners in Management of an Adult Patient with Class III Skeletal Malocclusion with Open Bite and Severe Bimaxillary Protrusion: Case Report

“…The first reported anterior cross bite case treated by serial clear aligners was in 2009 by Park and Kim [ 1 ] that showed serial clear aligners made in the laboratory were able to move teeth sequentially into normal occlusion. A recent study showed that clear aligners are as effective as fixed orthodontic appliances in correcting open bite cases [ 2 ]. Recent case reports showed that clear aligners could be successfully used to correct Class III malocclusion and open bite cases with or without surgery.…”