Long-term evaluation of rapid maxillary expansion and bite-block therapy in open bite growing subjects:

Abstract

Objective: To evaluate the long-term effects of rapid maxillary expansion (RME) and posterior bite block (BB) in prepubertal subjects with dentoskeletal open bite. Materials and Methods: The treatment group (TG) comprised 16 subjects (14 girls, 2 boys) with dentoskeletal open bite with a mean age of 8.1 6 1.1 years treated with RME and BB. Three consecutive lateral cephalograms were available before treatment (T1), at the end of the active treatment with the RME and BB (T2), and at a follow-up observation at least 4 years after the completion of treatment (T3). The TG was compared with a control group (CG) of 16 subjects (14 girls, 2 boys) matched for sex, age, and vertical skeletal pattern. An independent sample t-test was used to compare the T1 to T3, T1 to T2, and T2 to T3 cephalometric changes between the TG and the CG. Results: In the long term, the TG showed a significantly greater increase in overbite (þ1.8 mm), reduced extrusion of maxillary and mandibular molars (À3.3 mm), and, consequently, a significant decrease in facial divergence (À2.88) when compared with untreated subjects. Conclusions: The RME and BB protocol led to successful and stable recovery of positive overbite in 100% of the patients considered. Correction of open bite was associated with reduced extrusion of maxillary and mandibular molars with a significant improvement in vertical skeletal relationships when compared with the CG. (Angle Orthod. 2018;88:523-529.)

Palatal Vault Morphometric Analysis of the Effects of Two Early Orthodontic Treatments in Anterior Open Bite Growing Subjects: A Controlled Clinical Study

“…Our AOB patients were treated with RME and BB that controlled the vertical dimension reducing the extrusion of maxillary and mandibular molars and applying an intrusive force on the teeth and consequently on the bones. 13 When comparing QH/Cg vs CG, the GMM analysis showed signi cant differences in the morphometric shape of the palatal vaults. QH/Cg was slightly expanded than CG ones, while there were no variations in maxillary depth.…”

“…Compliance was assessed with a 3-point Likert-type scale (poor, moderate, good) 24 : poor compliance was reported when the patient wore BB at night only, moderate compliance occurred when the patient wore BB at night and during the day at home, and good compliance was assessed when the patient wore BB full-time, as suggested by the clinician. 13 QH/Cg used a QH/C made of 0.036-inch stainless steel wire, soldered to bands on the rst permanent molars or on the second deciduous molars. 25 The crib was made of three spurs of 0.036-inch stainless steel wire positioned on the anterior bridge of the QH/C to avoid thumb sucking.…”

“…Many Authors have emphasized that a skeletal open bite should be managed early in growing subjects by applying Rapid Maxillary Expander (RME) in association with a posterior Bite-Block (BB). [9][10][11][12][13] Instead, Quad-Helix with crib (QH/C) is used in patients with dentoalveolar open bite, often related to sucking habits. 9 In literature, different studies examined the craniofacial effects of these two early treatment protocols on lateral cephalometric radiographs using bidimensional conventional analysis.…”

Treatment of adult patient with hyperdivergent retrognathic phenotype and anterior open bite: report of a case with non-surgical orthodontic approach

“…In children and adolescents, anterior open bites with tongue thrust can be treated by fixed or removable appliances, with or without lingual spurs and cribs. [45][46][47] However, anterior open bites in adult patients are considered skeletal, since the positioning of the anterior teeth implies in permanently deformed dentoalveolar bases and, most of the time, malocclusion is treated with fixed orthodontic appliances and intermaxillary elastics. 48 Indeed, an orthodontic-surgical approach, with mandibular advancement and counterclockwise rotation of the occlusal plane, can be an alternative therapeutic plan for these cases 49 But orthognathic surgeries involve extra costs and risks, and provide no full guarantee of long-term stability.…”

Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open bite

“…Anterior open bite (AOB) is defined as the absence of contact of the anterior teeth when the posterior teeth are in contact. 1 , 2 , 3 It was established that heredity and several other factors (thumb and/or finger sucking, lip and tongue posture habits, impaired nasal breathing, and true skeletal growth abnormalities) play an important role in the etiology of this type of malocclusion. 4 , 5 , 6 , 7 The intrinsic vertical gap can cause difficulties in biting and chewing, affects the articulation and has unfavorable aesthetic and psychological consequences.…”