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At least 109 records · Page 6Linked to original sources
PubMed2001

Effect of orthognathic surgery on the temporomandibular joint in patients with anterior open bite.

This study examined the prevalence of temporomandibular joint (TMJ) signs and symptoms in patients with anterior open bite. The influence of orthognathic surgery on the TMJ in these patients and the interaction of occlusal and psychologic variables on the presence and/or persistence of pain was studied. A retrospective survey of 83 patients with an anterior open bite who underwent orthognathic surgery was carried out. Records were examined for the prevalence of abnormal TMJ signs and symptoms, including pain. A survey was mailed to these patients that consisted of: (1) the TMJ Scale, (2) the Symptom Checklist 90 (SCL90), (3) the Spielberger State-Trait Anxiety Inventory (STAI), and (4) a visual analog scale on which patients indicated their degree of satisfaction with the procedure. Thirty-seven (42%) patients responded to the survey, and 13 (15%) also attended a clinical and radiographic examination. Multiple regression analysis was used for statistical analysis of the factors contributing to the presence and/or persistence of pain. In the preoperative group, the prevalence of pain was 32%, dysfunction 40%, and limitation of opening 7%. Age and gender were significantly associated with the presence of pain. The overall prevalence of abnormal TMJ signs and symptoms was not significantly different after orthognathic surgery. An abnormal psychologic profile was the most significant factor associated with the presence and/or persistence of pain. It is concluded that that the prevalence of temporomandibular disorders in anterior open bite patients increases with age, is significantly higher in females, and is not influenced by other occlusal variables. Furthermore, orthognathic surgery does not significantly influence temporomandibular disorders in patients with anterior open bite. Female patients, particularly those with an abnormal psychologic profile, are at a higher risk of persistent postoperative TMJ pain.

Adolescent↗
PubMed2006

Segmental alveolar distraction for the correction of unilateral open-bite caused by multiple ankylosed teeth: a case report.

Ankylosed teeth fail to erupt to meet their counterparts in the opposite jaw. In cases where ankylosis occurs in multiple teeth, the occlusion shows an open bite. This article describes a case of unilateral open bite caused by multiple ankylosed teeth, where treatment involved segmental alveolar bone distraction. A 25-year-old female patient presented with a left-sided unilateral open bite. On the left-hand side, only the lower incisors were not ankylosed. On the right, the maxillary first molar was ankylosed. All these ankylosed teeth were positioned below the occlusal plane. Her mother and brother also had multiple ankylosed teeth, and a familial cause was considered. Orthodontic tooth movement was considered impossible and segmental osteotomy on the left maxillary alveolar bone and downward bone distraction were performed as an alternative. A distractor consisting of orthodontic bands, wires and screws was devised and worn in the left mandibular dentition. Multi-bracket orthodontic appliances were also used for distraction. The amount of vertical movement was 7 mm at the premolar region. Five months after distraction, the multibracket appliance was removed, and fixed and removable retainers were placed. Eight months after distraction, prosthodontic restorations on the occlusal surfaces of the ankylosed teeth were made to obtain the final occlusion. The unilateral open bite was successfully treated and a good occlusion was obtained. The occlusion has shown good long-term stability for more than 3 years.

Adult↗
PubMed2006

Nonextraction treatment of an open bite with microscrew implant anchorage.

A 16-year-old girl with an anterior open bite was treated with nonextraction therapy that included intrusion of the maxillary and mandibular posterior teeth with microscrew implants. Implants (diameter, 1.2 mm; length, 8 or 6 mm) were placed into alveolar bone near the posterior teeth and used as anchorage for intrusive force. To prevent adverse side effects of buccoversion or linguoversion of the posterior teeth during intrusion, a transpalatal bar and a lingual arch were placed. The 3-mm anterior open bite was corrected in 11 months of treatment, after intrusion of the maxillary and mandibular posterior teeth and autorotation of the mandible. The posterior intrusion relapsed in the early stage of retention, at 8 months; thereafter, no obvious relapse was evident in the vertical position of the molars and the FMA. The treatment mechanics of anterior open bite with posterior intrusion by using microscrew implants were effective but still require a proper retention protocol.

Adolescent↗
PubMed1992

Orthodontic and orthopaedic approach in the treatment of skeletal open bite.

The aim of this study was to make a detailed evaluation of the changes in the dentofacial structures that could be effective in the elimination of skeletal open bite. The study was performed on 32 skeletal open bite cases which were treated with Begg technique, Edgewise technique, and functional appliances and findings were analysed by multivariate statistical methods. Open bite was significantly reduced in all of the treatment groups. Apart from minor differences, similar changes were observed with Begg and Edgewise technique treatments. During fixed appliance therapy marked increases in the upper and lower posterior dentoalveolar height were observed, and the mandible rotated backwards. On the other hand, with the functional appliances vertical growth of the posterior upper and lower dentoalveolar region was depressed, and the mandible was rotated forwards and upwards with the centre at the premolars. These findings were confirmed by regression analysis: rotational changes in the maxillary and mandibular bases explained 46 per cent of variance of the reduction of open bite in the functional group, while 28 and 16 per cent of variance was explained in the Edgewise and Begg groups, respectively.

Activator Appliances↗
PubMed2004

The use of skeletal anchorage in open bite treatment: a cephalometric evaluation.

The aims of the present study were to assess the effectiveness of skeletal anchorage for intrusion of maxillary posterior teeth, to correct open bite malocclusion, and to evaluate the usage of titanium miniplates for orthodontic anchorage. Anterior open bite is one of the most difficult malocclusions to treat orthodontically. Currently, surgical impaction of the maxillary posterior segment is considered to be the most effective treatment option in adult patients. Various studies have reported the use of implants as anchorage units at different sites of midfacial bones for orthodontic tooth movement. The zygomatic buttress area could be a valuable anchorage site to achieve intrusion of maxillary posterior teeth. Ten patients, 17 to 23 years old and characterized with an anterior open bite and excessive maxillary posterior growth, were included in this preliminary study. Titanium miniplates were fixed bilaterally to the zygomatic buttress area, and a force was applied bilaterally with nine mm Ni-Ti coil springs between the vertical extension of the miniplate and the first molar buccal tube. The results showed that, with the help of skeletal anchorage, maxillary posterior teeth were intruded effectively. As compared with an osteotomy, this minimally invasive surgical procedure eased treatment and reduced treatment time and did not require headgear wear or anterior box elastics for anterior open bite correction. In conclusion, the zygomatic area was found to be a useful anchorage site for intrusion of the molars in a short period of time.

Adolescent↗
PubMed1975

Correction of severe open-bite associated with muscular disease. Report of a case.

A 14-year-old boy presented with a severe open-bite and arch collapse associated with muscular disease. Multiple osteotomies of the maxilla and mandible with autogenous bone grafting were used for surgical closure of the open-bite. A satisfactory and stable skeletal result was achieved. The patient was then referred for orthodontic therapy to achieve a better dental interdigitation and maintenance of the newly created relationship. In severe cases of open-bite multiple osteotomies of the mandible and maxilla may need to be performed in order to accomplish the desired results. These same results may not be ach ieved by any single surgical procedure. The relationship between severe open-bite and muscle diseases needs to be further established. Once these etiologic factors are known, steps could perhaps be taken to alter the maldevelopment of the facial skeleton. Until this happens, the symptoms are best treated by a combination of surgical and orthodontic intervention.

Adolescent↗
PubMed1999

Cephalometric evaluation of open bite treatment with NiTi arch wires and anterior elastics.

The aim of this study was to evaluate cephalometrically the effects of open bite treatment with NiTi arch wires and anterior elastics. The study group comprised of 17 patients who displayed a high angle skeletal pattern, along with an anterior open bite. After initial leveling, 0.016 x 0.022 inch upper accentuated-curve and lower reverse-curve arch wires were placed, with anterior elastics applied in the canine regions. Cephalometric assessment was carried out on lateral head films taken at the beginning of treatment and on average 2.8 months after open bite closure was obtained. The results of this study indicated that open bite closure had been achieved mainly by extrusion of the lower incisors and uprighting of the upper incisors. The functional occlusal plane was leveled by extrusion of lower premolars and uprighting of lower molars. Lateral cephalograms obtained from 10 patients who had been available after 1 year postretention were used to evaluate relapse changes. During the follow-up period, position of the upper and lower incisors and the inclination of the occlusal plane were maintained. However, extrusion of upper and lower molar teeth resulted in a reduction in overbite.

Adolescent↗
PubMed2001

Skeletal and dento-alveolar stability after surgical-orthodontic treatment of anterior open bite: a retrospective study.

The aim of this investigation was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction of skeletal anterior open bite treated by maxillary intrusion (group A) versus extrusion (group B). The cephalometric records of 49 adult anterior open bite patients (group A: n = 38, group B: n = 11), treated by the same maxillofacial surgeon, were examined at different timepoints, i.e. at the start of the orthodontic treatment (T1), before surgery (T2), immediately after surgery (T3), early post-operatively (+/- 20 weeks, T4) and one year post-operatively (T5). A bimaxillary operation was performed in 31 of the patients in group A and in six in group B. Rigid internal fixation was standard. If maxillary expansion was necessary, surgically assisted rapid palatal expansion (SRPE) was performed at least 9 months before the Le Fort I osteotomy. Forty-five patients received combined surgical and orthodontic treatment. The surgical open bite reduction (A, mean 3.9 mm; B, mean 7.7 mm) and the increase of overbite (A, mean 2.4 mm; B, mean 2.7 mm), remained stable one year post-operatively. SNA (T2-T3), showed a high tendency for relapse. The clockwise rotation of the palatal plane (1.7 degrees; T2-T3), relapsed completely within the first post-operative year. Anterior facial height reduction (A, mean -5.5 mm; B, mean -0.8 mm) occurred at the time of surgery. It can be concluded that open bite patients, treated by posterior Le Fort I impaction as well as with anterior extrusion, with or without an additional bilateral sagittal split osteotomy (BSSO), one year post-surgery, exhibit relatively good clinical dental and skeletal stability.

Adolescent↗
PubMed2002

Closing anterior open bites by intruding molars with titanium miniplate anchorage.

The intent of this study was threefold: (1) to validate true intrusion of molars in adults, (2) to test the stability of miniplates as anchorage for intruding posterior teeth in the maxilla, and (3) to record the skeletal and dental changes of open-bite closure. Four adult patients who had anterior open-bite malocclusions were selected to undergo posterior intrusion with miniplate anchorage to close the open bite; all had true intrusion of the maxillary molars. Mean molar intrusion was 1.99 mm (range, 1.45-3.32 mm). No movement of miniplates occurred at any time during their use or before intentional clinical removal. Open-bite closure was achieved for all 4 patients. Mean closure of incisors was 3.62 mm (range, 3.0-4.5 mm) as the mandibular plane closed 2.62 degrees (range, 1.5 degrees -4.5 degrees ), and the occlusal plane decreased 2.25 degrees (range, 1.0 degrees -3.5 degrees ). Anterior facial heights decreased as the mandible closed and B-point rotated anteriorly and upward.

Adult↗
PubMed1982

An investigation of the association between anterior open-bite and amelogenesis imperfecta.

Fifty subjects with amelogenesis imperfecta were investigated clinically and with cephalometric radiography in order to determine the prevalence and nature of the anterior open-bite, which has been reported in association with these enamel defects. Anterior open-bite occurred in 24 percent of the subjects and was always associated with a severe discrepancy in the vertical relationship of the jaws. This vertical dysgnathia also occurred in a further 20 percent who did not have anterior open-bite. It is suggested that the frequent association of anterior open-bite and amelogenesis imperfecta is caused by a genetically determined anomaly of craniofacial development, rather than by local factors influencing alveolar growth.

Adolescent↗
PubMed1993

The hyoid bone position in adult individuals with open bite and normal occlusion.

The position of the hyoid bone was studied in 39 adult subjects with long face syndrome and an open bite of at least 2 mm (16 males and 23 females) and 43 adult subjects with normal Class I occlusion (25 males and 18 females). Several measurements were used to determine the horizontal, vertical, and axial orientation of the hyoid bone. Comparisons were based on paired t-test, which were performed separately for the male and the female groups. Most of the horizontal measurements showed no difference in the position of the hyoid bone in both male and female open bites when related to normals. As far as vertical measurements only the distance from hyoid bone to palatal plane was found significantly greater in the male open bite group due to the position of the palatal plane in the development of this dentoskeletal malocclusion. The hyoid axis formed significantly higher angles with the basion-nasion plane as well as with the palatal plane in the open bite groups, while there was no difference in the angle formed by hyoid axis and mandibular plane. The findings strongly suggest that hyoid bone moves in close conjunction with the pharynx, cervical spine, and mandibular plane in patients with entirely different skeletal patterns.

Adolescent↗
PubMed2000

Long-term dentofacial stability after bimaxillary surgery in skeletal Class III open bite patients.

The purpose of this study was to evaluate long-term dentofacial stability after bimaxillary surgery in skeletal Class III open bite patients. Twenty-three Japanese adults (5 males, 18 females) were randomly selected as the experimental group from the files of Tohoku University Dental Hospital according to the following criteria: (1) skeletal Class III malocclusion with anterior open bite, (2) simultaneous Le Fort I and sagittal split ramus osteotomies, and (3) complete set of cephalograms taken at predetermined intervals until 5 years after debonding. Based on the manner of maxillary surgical repositioning, they were divided into the following 2 groups: (1) impaction group of 13 subjects (2 males, 11 females) who had maxillary superior repositioning without rotation of the palatal plane, and (2) rotation group of 10 subjects (3 males, 7 females) who had maxillary repositioning with clockwise rotation of the palatal plane. These patients were compared to a control group of 11 adults (1 male, 10 females) with skeletal Class III malocclusion without open bite who underwent bimaxillary surgery by the same techniques. Our data showed that overbite stability in the rotation group was better than that in the impaction group. This suggests that clockwise rotation of the palatal plane, which moves the anterior maxillary structures down, is an effective way to produce a reasonably stable correction of the anterior open bite. In contrast, superior repositioning of the maxilla that significantly rotates the mandible in the closing direction should be applied with caution.

Adolescent↗
PubMed1992

[Anterior open bite].

In almost 50% of the Dutch population, the mandibular incisors do not contact the maxillary ones. An open bite is usually based on an interposition of the tongue and can be combined with other functional disturbances as digit sucking. A large open bite with an excessive facial deformity can be treated adequately, after facial growth is completed, by a combined orthodontic-surgical approach, in which a good cooperation between the orthodontist and the oral surgeon is essential. The correction of the facial deformity is of a permanent nature. That does not always apply to the open bite due to interposition of the tongue. Often it is not possible to arrive at complete contact by orthodontic or surgical means. The improvement realized can fade away partly in the years following.

Fingersucking↗
PubMed1990

Combined orthodontic and restorative correction of severe anterior open bite.

This article describes a multidisciplinary approach to the treatment of a severe skeletal anterior open bite, complicated by severe chronological enamel hypoplasia, in a 12-year-old southern Chinese girl. Correction of the open bite, of which the cause was unknown, involved the extraction of all first permanent molars and provisional repair of the wafer-thin enamel to permit bonding of fixed orthodontic brackets. Several phases of maxillary and mandibular fixed appliance therapy followed. As the open bite resolved, further restorative treatment was performed. The result was stable 3 years after the end of retention. This case demonstrates the benefits of well-planned, integrated, multidisciplinary treatment.

Cephalometry↗
PubMed2006

Cephalometric correction factors for bite opening--a dry skull study.

The lateral cephalometric radiograph supplies the clinician with valuable information regarding the facial skeletal morphology of the patient, provided that it is taken correctly. These radiographs should be taken while the patient is occluding in maximum intercuspation, failing which the exposure is often repeated, leading to an increase in patient radiation dose as well as added cost in time and materials. This study investigated the relationship between limited bite opening and selected cephalometric variables. Thirty-one dry skulls were used and five splints were constructed for each skull giving increments of bite opening from 0 to 5 mm. Six lateral radiographs per skull were taken at each increment of bite opening. The radiographs were traced and the points plotted using a reflex metrograph. A linear relationship was found between bite opening and SNB, ANB, SN-mandibular plane, and SN-Y-axis angles. Errors in digitization, superimposition, and landmark identification were determined and found to be acceptable. Regression analysis produced a highly significant (P < 0.001) gradient for each of these angular relationships, allowing a set of correction factors to be produced, which can be applied to bite openings up to 5 mm.

Cephalometry↗
PubMed1992

Patterns of incisor root resorption before and after orthodontic correction in cases with anterior open bites.

External root resorption is a frequent iatrogenic consequence of orthodontic treatment, particularly in the maxillary anterior teeth. Since resorption also occurs is a normal function of aging and since altered behaviors such as bruxism and chronic nailbiting accelerate resorption even in the absence of treatment, it was hypothesized that the long-term orthopedic forces of tongue thrusting leading to anterior open bites would also enhance the rates of clastic activity. In a series of 32 adolescents with open bites, the roots of permanent maxillary central incisors were significantly shorter and exhibited higher modal grades of periapical resorption than a matched series with deep bites before treatment. The open bite group also had less facial bony support for these teeth. Both series experienced discernible resorption during full-banded treatment but to comparable extents so that, after active treatment, the open bite series continued to possess significantly greater degrees of resorption. Consequently, the oral forces leading to apertognathia are themselves destructive of root integrity and merit early recognition and interception.

Adolescent↗
PubMed2003

Stability of anterior open bite nonextraction treatment in the permanent dentition.

This study cephalometrically evaluated the long-term stability of anterior open bite nonextraction treatment in the permanent dentition after a mean period of 5 years. The experimental group consisted of 21 patients who had undergone orthodontic treatment with fixed appliances from whom cephalometric headfilms were obtained at the pretreatment, posttreatment, and postretention stages. Two control groups were used. The first, with ages comparable with the experimental group before treatment, was used only to characterize it. The second control group, with normal occlusion, was longitudinally followed for a period comparable with the posttretention period and was used to compare the changes between groups during this period. The differences between the observation stages in the experimental group were analyzed with paired t tests, and the postretention changes were compared with the changes of the second control group with independent t tests. A statistically significant decrease of the obtained anterior overbite was demonstrated at the end of the postretention period. The primary factor that contributed to the overbite decrease was the smaller vertical development of the maxillary and mandibular incisors in the postretention period. Neither the pretreatment anterior open bite amount nor the magnitude of correction was associated with the long-term overbite decrease. However, 61.9% of the sample had a clinically stable open bite correction.

Adolescent↗
PubMed2006

Impairment of the oral stereognosis in the partial anterior open bite.

The study was performed in 20 children with partial anterior open bite and in 20 children of a control group. Stereognosis was evaluated on the basis of correct recognition responses to silicone pieces of the different shapes. Pieces were put on the dorsal surface of the tongue close to its apex. It was evident that the stereognostic ability was impaired in children with anterior open bite. This ability also decreased after infiltration anaesthesia of the tongue. The study indicated that the tongue plays an important role in oral stereognosis.

Adolescent↗