Stability of intercanine width, overbite, and overjet correction.
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Anterior open bites may be localized dental manifestations, which are caused by habits or skeletal disharmony, with or without functional aberration. Previous studies suggest various associations between open bites and underlying etiologic factors. We hypothesize that respiratory efficiency may be associated with anterior open bites. Under the assumption that breathing efficiency of the oropharynx and hypopharynx may be related to pharyngeal airway length, a cephalometric variable, vertical airway length (VAL), was measured on lateral cephalograms obtained from a total of 58 subjects with, so called, "open bite tendencies" (hereafter, open bite tendency). By means of the variable VAL, the association between pharyngeal length and open bite was investigated. In addition, the difference between actual open bite and open bite tendencies was also examined. The samples were randomly collected under stringent selection criteria from an existing database. A series of statistical analyses, such as unpaired t test, multiple regression, and discriminant analysis, was used to test the proposed hypothesis. The study found that none of the open bite tendency indicators used can segregate open bite subjects from nonopen bite subjects. The obtained discriminant function clearly divides the samples into two groups, i.e., open bite group and nonopen bite group, which were based on VAL and lower facial height. The study concludes that, first, an open bite tendency may be a different entity from an actual open bite or may be a misconceptualized term. Second, pharyngeal length may be a convenient indicator to diagnose open bite. We speculate that open bite may be different from an open bite tendency in pharyngeal length.
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Oral habits should be of primary clinical concern to orthodontists because they may cause malocclusion, and/or interfere with treatment progress. Generally habit control should be achieved prior to correction of the malocclusion in an effort to remove any etiological factors in development and maintenance of the malocclusion. It is also important for the clinician to understand that habit-breaking treatment may require an extended treatment time because habits may have been present for long periods of time and may be related to underlying psychological problems. The present report documents the treatment of maxillary protrusion in a patient in which a thumb-sucking habit had persisted from infancy until almost age 12. Elimination of the habit was accomplished prior to correcting the malocclusion and for stability of the result. Orthodontic treatment consisted of extracting two maxillary premolars followed by full treatment with fixed appliances. Long-term postretention records show good stability of the corrected malocclusion.
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