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This single-center trial aimed to longitudinally compare the oral health-related quality of life (OHRQOL), adaptation and discomfort during anterior open bite (AOB) treatment with lingual spurs and build-ups (SBU) versus spurs only (S) approaches. Children (7–11 years) with AOB were randomly allocated into two treatment groups (SBU or S). The Child Perception Questionnaire (CPQ 8–10 ) was applied 1 and 12 months after installation of the appliances. Questionnaires evaluating functional adaptation and discomfort during the first month of treatment were also applied. A visual analog scale (VAS) was used in these questionnaires. Generalized mixed models were used for analyzing OHRQOL and discomfort data. Generalized linear models were used to assess adaptation outcomes (α = 0.05). The SBU group included 24 patients (7 males and 17 females; mean age 8.2 years) and the S group included 25 patients (11 males and 14 females; mean age 8.3 years). Regardless of the treatment type, overall OHRQOL scores at 12 months were 0.69 times those recorded at 1 month after the appliances installation (i.e., ~ 31% reduction; exp (β) = 0.69; 95% CI: 0.55, 0.88). A significant interaction between treatment and time was detected for the ‘functional limitations’ domain. For this domain, a significant improvement from the first to the twelfth month was observed in the S group ( P  < 0.001). Patients in both treatment groups showed similar and easy adaptation to the appliances. Independent of the type of treatment, tongue-related discomfort decreased over time. One week and one month after the appliance’s delivery, the discomfort scores were 0.19 (i.e., ~ 81% reduction; exp (β) = 0.19; 95% CI: 0.13, 0.28; P  < 0.001) and 0.02 (i.e., ~ 98% reduction; exp (β) = 0.02; 95% CI: 0.01, 0.07; P  < 0.001) times, respectively, those issued immediately after the installation of the appliances. Regardless of treatment type; overall OHRQOL improved from the first to the twelfth month of AOB treatment. The functional limitations score decreased in the S group. Children showed easy adaptation, and their discomfort decreased 1 week after the installation of the appliances. Trial registration: Clinicaltrials.gov; NCT03702881, date of registration: October 11, 2018.

This randomized clinical trial aimed to compare the three-dimensional dentoalveolar maxillary changes after anterior open bite treatment with bonded spurs and build-ups versus bonded spurs alone. Patients from 7 to 11 years of age with anterior open bite were randomly allocated into two groups. Bonded spurs and posterior build-ups were used in the experimental group and only bonded spurs were used in the comparison group. The randomization sequence was generated at www.randomization.com . Opaque, sealed and sequentially numbered envelopes were part of the allocation concealment. Digital dental models were acquired before (T1) and after 12 months of treatment (T2) and de-identified for analysis purposes. Three-dimensional changes of maxillary permanent incisors and first molars were evaluated by means of T1 and T2 dental model superimposition. Landmark-based registration on the posterior teeth and registration on the palate using regions of interest were performed. T or Mann–Whitney U tests were used for intergroup comparisons ( P  < 0.05). Mean difference (MD) and 95% confidence interval (CI) were calculated. Twenty-four children (17 girls and 7 boys) were included in the experimental group (mean age 8.22 ± 1.06 years) and 25 children (14 girls and 11 boys) were included in the comparison group (mean age 8.30 ± 0.99 years). After 12 months of treatment, inferior displacements of maxillary incisors were similar in the experimental (1.55–2.92 mm) and comparison (1.40–2.65 mm) groups. Inferior displacement of the maxillary molars was also similar in both groups (MD: − 0.13 mm; 95% CI − 0.38, 0.12). The experimental and comparison groups showed medial and lateral displacements of the permanent first molars, respectively (MD, − 0.31 mm; 95% CI − 0.51, − 0.11). Lingual inclination of the permanent first molars were observed in the experimental group and buccal inclination in the comparison group (MD, − 2.16°; 95% CI − 3.72, − 0.60). Similar three-dimensional displacements of maxillary central and lateral incisors, and inferior displacements of maxillary permanent first molars were observed in both groups. Bonded spurs associated with posterior build-ups demonstrated some medial displacement and lingual inclination of the maxillary permanent first molars while opposite changes were noticed in the comparison group. Trial registration: Clinicaltrials.gov; NCT03702881, date of registration: October 11, 2018.

Background Anterior open bite is a challenging condition for pediatric dentists and orthodontists as it causes aesthetic, speech, feeding, and psychological problems; this emphasizes the need for early diagnosis and interception of this malocclusion. Aim This study aimed to evaluate the effects of prefabricated metal-bonded tongue tamers and customized bonded spurs in the early treatment of anterior open bite. Materials and methods A sample of seventy-five children aged 7–9 years were assigned into three groups in which anterior open bite was treated using tongue tamers (group-I), customized composite bonded spurs(group-II), and conventional fixed palatal cribs (group-III). Study model and cephalometric x-ray evaluations were done before and after a three-month follow-up. Data was gathered and statistically analyzed using ANOVA and Bonferroni tests. Results Model overbite at central and lateral incisors was increased in all groups. The highest increase was found in group-I(3.16 ± 1.17, 2.81 ± 0.94)and group-III(3.08 ± 1.10,2.99 ± 1.00) though the difference was not statistically significant. Also, cephalometric overbite was non-significantly increased in all groups with a high increase in group-III(3.13 ± 1.10). Overjet decreased in all groups, with the greatest reduction observed in group-I(-2.58 ± 1.02 and -2.47 ± 0.80 in model and cephalometric respectively) and was significantly different from group-II using pairwise analysis. There was a decrease in SNA and ANB in all groups with more significant improvement in groups-I(-1.20 ± 0.88,-1.65 ± 0.74) and -III(-1.31 ± 0.92, -1.62 ± 0.75) than group-II(-0.63 ± 0.46, -0.90 ± 0.43). Moreover, FMA measurements decreased significantly in group-I (-2.6 ± 1.11). Regarding SNB measurement, there was a non-significant increase in all three groups with the highest increase in group-I(0.49 ± 0.48) followed by group-III(0.34 ± 0.63). The U1/FHP and L1/GoGn angles were non-significantly decreased in all tested groups with the highest decrease in group-I(-1.76 ± 1.00 and-2.54 ± 0.87 respectively). Conclusion Early treatment of anterior open bite, along with tongue tamers' simplicity and aesthetics promoted the malocclusion correction and occlusal function restoration. Trial registration ClinicalTrials.gov, NCT05792553 , “Effects of Tongue Tamers as an Early Treatment of Anterior Open Bite”, Retrospectively registered: 31/03/2023.

Background There are different intraoral appliances for cessation of thumb/finger sucking habit, but they have many disadvantages and to overcome it, extra oral appliances with colourful and attractive shape were developed. Electronic habit reminder in the form of wristwatch with alarming sound was assessed in cessation of thumb/finger sucking habit in children versus palatal crib after 6 and 9 months. Methods This study is a randomized clinical pilot study, with allocation ratio 1:1 parallel group. Recruitment was at the diagnostic clinic, Paediatric Dentistry and Dental Public health Department, Faculty of Dentistry, Cairo University. Blinding was not feasible except for the statistician. Twenty-two children were included with age range (6–14), erupted upper first permanent molar and with thumb/finger sucking habit that resulted in open bite. After random allocation of participants into two groups: intervention group (electronic habit reminder) and control group (palatal crib), impressions were performed for fabrication of the appliances in both groups. Follow up was performed at 2 weeks, 1, 3, 6 and 9 months. Primary outcome was assessing cessation of thumb/finger sucking habit in children. Results The total number of participants who were randomized and analysed was 22 (11 per group). Cessation of thumb/finger sucking habit in the intervention group was 27.3% while in the control group was 54.5% but with no statistically significant difference ( P˃ 0.05). Positive feedback from the parents about the useful instructions, success, and ease of using the appliances but all with no statistically significant difference ( P˃ 0.05). Harms Regarding the palatal crib appliance, there was gingival inflammation that resolved by proper oral hygiene care. Also, interference with speech which disappeared after adaptation. Regarding appliances breakage or dislodgment, it was repaired or replaced with another one. Conclusion Although most of the parents and children accepted both appliances, cessation of the habit was higher in the control group than in the intervention group. Trial registration The trial was registered on clinicaltrials.gov, ‘Trial registration number: NCT04075617 [first submitted -29/8/2019]’.

Background Anterior open bite (AOB) malocclusion usually represents a complicated and advanced orthodontic problem. The skeletal variant of AOB used to be treated with a combined orthodontic and surgical approach, until the posterior segments’ intrusion has been validated as an alternative, effective and conservative treatment modality for such cases with comparable outcomes to the surgical approach. The objective of this two-arm parallel randomized clinical trial was to compare the effects of mini-screw supported maxillary versus bi-maxillary buccal segments’ intrusion on the amount of anterior open bite closure. Methods Twenty-two adult patients aged 17–25 years, with skeletal open bite and anterior dental separation of 3–8 mm were randomized to either the comparator (Maxillary Intrusion with Consolidation of mandibular buccal segments-MIC) or intervention (Bimaxillary buccal segments’ intrusion-BMI) groups. Miniscrew-assisted buccal segments’ intrusion was instituted using fixed appliances on rigid stainless steel archwires (19 × 25 stainless steel) via nickel-titanium coil springs in the maxilla and memory chains in the mandible. The intrusion force was 200 g per maxillary buccal segment in both groups, and it was 150 g for each mandibular posterior segment in the BMI group. Duration of intrusion was 6 months. Results Anterior open bite was significantly closed in both groups with means of 3.8 ± 0.84 (95% confidence interval [CI] 3.2–4.4) and 3.84 ± 1.47 mm (CI;2.8–4.9) for the MIC and BMI groups, respectively with no significant difference between them (p-value < 0.05). Maxillary posterior teeth experienced significant intrusion in both groups, with a mean of 2.89 ± 1.13 mm (CI;2.63–3.14) in the MIC group and 2.26 ± 1.62 mm (CI;1.89–2.62) in the BMI group. Statistically significant mandibular posterior teeth intrusion occurred in both groups with means of 0.86 ± 0.91 (CI;0.65–1.06) and 0.33 ± 0.84 mm (CI;0.14–0.52) in the BMI and MIC groups, respectively, with a statistically significant difference of 0.53 ± 0.14 (CI;0.25–0.8) mm. However, such difference was considered clinically insignificant. Conclusions Anterior open bite closure could be successfully achieved with maxillary buccal segments intrusion without the need for active intrusion of the mandibular posterior segments, as long as the latter are efficiently consolidated. Trial registration The trial was prospectively registered at clinicaltrials.gov with an identifier number of NCT04713280.

Backgound This study cephalometrically evaluated the posterior teeth angulation changes of anterior open-bite non-extraction and extraction treatment in the permanent dentition, with anterior vertical elastics. Methods The sample consisted of initial and final lateral headfilms of 60 patients divided into 2 groups: Group 1 consisted of 30 patients treated with non-extraction with an initial mean age of 15.26 years and treated with fixed appliances for a mean period of 2.46 years. Group 2 consisted of 30 patients treated with extractions, with an initial mean age of 14.03 years, and treated with fixed appliances for a mean period of 2.49 years. Within-group treatment changes were evaluated with paired t tests. Results were considered statistically significant at P  < 0.05. Results The mandibular posterior teeth were significantly uprighted in both groups with both treatment protocols. Conclusions Correction of anterior open bite with either non-extraction or extractions with continuous archwires and vertical anterior elastics uprights the mandibular posterior teeth.

Open-Bite Malocclusion: Treatment and Stability presents the etiology, treatment, and its stability of anterior open bite malocclusion in the early, mixed, and permanent dentitions. Special emphasis is devoted to orthodontic treatment and its stability in the permanent dentition because this is the time when treatment of open bite presents greater relapse. Appropriate for clinicians, orthodontic residents, and dental students, Open-Bite Malocclusion covers the most simple treatment approaches to the most complex, from orthodontic devices to tooth extraction to surgery. Unique to this book is the discussion of post-treatment stability. Drs. Janson and Valarelli highlight the post-treatment changes and presents strategies to increase treatment stability. This allows the clinician to be able to predict the stability probabilities when treating anterior open bite malocclusions in the permanent dentition either with or without extraction, orthodontic-surgical therapy, or with occlusal adjustment.

Lateral cephalograms have the inherent drawback of superimposition of bilateral structures, while landmarks are more reproducible on CBCT scans. Yet no studies in the literature have utilized 3D imaging to investigate the effects of clear aligners on anterior open bite. Therefore, The aim is to measure the skeletal and dental changes that contribute to anterior open bite closure with clear aligner therapy on CBCT scans. It is a single-arm retrospective study that included 40 cases of anterior open bite who were treated using Invisalign. Pre- and post-treatment CBCT scans were traced to record 13 dental and 3 skeletal measurements. A paired t-test was conducted to compare the mean values of pre- and post-treatment measurements. Combined intrusion of the maxillary right and left molars was statistically significant, meanwhile mandibular molars maintained their vertical position. Maxillary incisors were extruded and retroclined significantly, whereas mandibular incisors were only extruded. While anterior facial height was decreased insignificantly, both lower anterior facial height and mandibular plane angle showed a significant decrease. Clear aligner (Invisalign) therapy is effective in the management of anterior open bite through vertical control, maxillary molars intrusion, maxillary incisors extrusion, maxillary and mandibular incisors retroclination, and mandibular autorotation.

Objectives This study aimed to compare treatment efficacy and cephalometric outcomes between extraction and non-extraction MEAW therapies in non-growing open-bite patients. Materials and methods 22 Multiloop Edgewise Archwire MEAW patients (11 males, 11 females) and 15 bicuspid extraction patients (3 males, 12 females) were selected according to a strict inclusion criterion. Comprehensive data collection related to age, sex, Cervical Vertebral Maturation CVM staging, and severity of the Anterior Open Bite AOB (1 = 0–1 mm; 2 = 1–2 mm; 3 = > 2.1 mm) was performed independently and in duplicate by 2 examiners. Each included patient’s pre and post-treatment lateral cephalograms were traced and compared. The primary outcomes assessed were related to the efficacy of treatment: treatment duration and time needed to achieve a positive overbite. The secondary outcomes assessed were related to the post-treatment changes in cephalometric measurements between the groups. Descriptive statistics, Mann-Whitney U test, unpaired student’s t-test, and Chi-squared were used for data analysis. Results The mean change in open bite closure was 3.07 ± 2.07 mm in the MEAW group and 3.03 ± 2.28 mm in the extraction group ( P  > 0.05). MEAW therapy was 31% faster (118 weeks) than extraction therapy (171 weeks, P  = 0.004). MEAW appliance showed a significantly shorter duration for open bite closure (71.82 ± 29.57 weeks) compared to the extraction group (127.25 ± 51.97 weeks, P  = 0.002). A greater decrease in the U1-SN was seen in the extraction group (-8.70 ± 6.49°), compared to the MEAW group (-2.56 ± 7.36°, P  = 0.047). The IMPA angle showed a greater decrease in the extraction group (-8.30 ± 8.85°) compared to the MEAW group (-0.90 ± 6.50°, P  = 0.032). The (L6-MP perp) increased in the extraction group by (1.98 ± 3.43 mm), while decreased in the MEAW group (-0.43 ± 1.38 mm, P  = 0.023). Conclusion In anterior open bite cases with bicuspid extraction, achieving a positive overbite typically involves retroclining and uprighting the upper and lower incisors (drawbridge effect). In contrast, the MEAW appliance focuses on uprighting the entire dentition and intruding the posterior teeth, often leading to shorter treatment durations. Clinical relevance The MEAW appliance’s biomechanical advantage in uprighting posterior teeth in open bite cases may shorten treatment duration for correcting open bite malocclusion.

Objectives Anterior open bite can be treated non-surgically via molar intrusion using temporary skeletal devices (TAD). Clear aligner therapy (CAT) is recognized as a viable therapeutic modality for non-extraction treatment of adults with mild open bite. This study aimed to compare the treatment effect and mechanisms of open bite closure between patients treated with braces and TADs double arch intrusion and those treated with CAT. Treatment success at T3 was based on 1- positive overbite on ceph; 2- Change in the vertical dimension 3- post treatment POSI score equal to zero. Material and Methods The TAD group includes 18 consecutively treated patients from the main author. The CAT group consisted of 16 selected patients from three different orthodontists. The observation time points were as follows: pretreatment (T1), end of molar intrusion and positive overbite achieved (T2), end of treatment (T3), at least 6-month follow-up (T4). Treatment changes were assessed by cephalometric analysis and frontal intraoral photo. Results At the end of treatment, 100% of the patient of the TAD group and 78,6% of the CAT group had a posi score of 0. The TAD group showed a significant reduction in vertical measurements (SN-MPA: -1,55° ± 0.41, LAFH: -3,05 ± 0.51 mm, U6-PP: -1.48 ± 0.30 mm), but the CAT group did not have significant changes for these variables. Both groups had significant increases in overbite from T1 to T3 (TAD: 4,32 ± 0,5 mm; CAT: 2,33 ± 0.56 mm), and overbite remained stable at T4. The CAT group did not have a significant upper molar intrusion, but a significant extrusion of 1.22 ± 0.42 mm of the lower incisor occurred. Conclusion The TAD group achieved bite closure by upper molar intrusion, lower molar and incisors vertical control, and mandibular plane counterclockwise rotation, resulting in an improved AP and vertical relationship. The CAT group achieved bite closure through the lower incisor extrusion without significant change in the vertical dimension. Clinical relevance This study provides relevant information about the skeletal and dental changes of open bite treatment with TADs double arch intrusion. The comparison with a control group treated with CAT confirms known information.