Dataset Information

Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial.

ABSTRACT: Objective The aim of the study was to evaluate skeletal, dentoalveolar, and soft tissue changes following early anterior open bite (AOB) treatment using a rapid molar intruder (RMI). Materials and methods A two-arm, parallel-group, randomized controlled trial was conducted on 40 patients aged 8-12 years with anterior open bites. They were randomly allocated to the RMI group and the untreated control group (UCG) with a 1:1 allocation ratio. At the beginning of the treatment (T1) and after nine months of treatment (T2), lateral cephalometric images were taken of each patient. The primary outcome measures were skeletal, dentoalveolar, and soft tissue changes. A two-sample t-test was used in the intergroup comparisons of the cephalometric measurement. Results The findings showed that the overbite increased significantly in the RMI group compared to the control group (x = 4.44 mm, x = 0.19 mm, respectively; p<0.001). A statistically significant intrusion of the upper and lower first molars was observed in the RMI group (x = 2.9 mm, x = 1.54 mm, respectively) compared to a slight extrusion in the control group. The differences between the two groups were significant (p<0.001). The SN: GoMe angle and the sum of Bjork decreased significantly in the RMI group compared to an increase observed in the control group. The differences between the two groups were significant (p<0.001). Conclusion The rapid molar intruder is an effective appliance for correcting anterior open bites in mixed dentition, inducing favorable skeletal, dentoalveolar, and soft tissue changes.

SUBMITTER: Hasan AA

PROVIDER: S-EPMC9774995 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial.

Hasan Amjad Ali AA Zeidan Hammam M HM Hajeer Mohammad Y MY Al-Jundi Azzam A Al-Sabbagh Rabab R Khattab Tarek Z TZ Al-Munajed Mohamad Kusai MK

Cureus 20221222 12

Objective The aim of the study was to evaluate skeletal, dentoalveolar, and soft tissue changes following early anterior open bite (AOB) treatment using a rapid molar intruder (RMI). Materials and methods A two-arm, parallel-group, randomized controlled trial was conducted on 40 patients aged 8-12 years with anterior open bites. They were randomly allocated to the RMI group and the untreated control group (UCG) with a 1:1 allocation ratio. At the beginning of the treatment (T1) and after nine mo ...[more]

PMID: 36570108

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Project description: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.

Project description:IntroductionAnterior open bite (AOB) continues to be a challenging malocclusion for orthodontists to treat and retain long-term. There is no consensus on which treatment modality is most successful. This study reports on the overall success rate of AOB orthodontic treatment in the adult population across the United States, as well as 4 major treatment modalities and other factors that may influence treatment success.MethodsPractitioners and their adult patients with AOB were recruited through the National Dental Practice-Based Research Network. Patient dentofacial and demographic characteristics, practitioner demographic and practice characteristics, and factors relating to orthodontic treatment were reported. Treatment success was determined from posttreatment (T2) lateral cephalometric films and intraoral frontal photographs. Treatment was categorized into 4 main groups: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also evaluated. Bivariate and multivariable models were used to investigate the association between treatment success and treatment modality, pretreatment (T1) dentofacial characteristics, patient and practitioner demographics, and practice characteristics, adjusting for clustering of patients within practice.ResultsA total of 254 patients, enrolled by 84 practitioners, contributed to T2 data for this study. There were 29 patients in the aligner group, 152 in fixed appliances, 20 in TADs, and 53 in surgery. A total of 49 patients underwent extractions of teeth other than third molars. Ninety-three percent finished treatment with a positive overbite on the T2 lateral cephalogram, and 84% finished with a positive vertical overlap of all incisors. The small number of aligners and TAD patients limited the ability to compare success rates in these groups. Patients treated with orthognathic surgery had a higher rate of success compared with those treated with fixed appliances only. Treatment success was also associated with academic practice setting, T1 mandibular plane angle ≤30°, no to mild T1 crowding, and treatment duration <30 months.ConclusionsThe overall success of orthodontic treatment in adult patients with AOB who participated in this study was very high. Orthognathic surgery was the only treatment modality that exhibited a statistically higher odds of successful outcomes. Some T1 dentofacial characteristics and treatment factors were associated with the successful closure of AOB.

Project description:IntroductionThis article evaluates and reports on the satisfaction of adult patients across the United States who received orthodontic treatment for anterior open bite malocclusion. The factors that influence satisfaction are also described.MethodsPractitioners were recruited from the National Dental Practice-Based Research Network. On joining the Network, practitioner demographics and information on their practices were acquired. Practitioners enrolled their adult patients in active treatment for anterior open bite. Patient demographics, patient dentofacial characteristics, and details regarding previous and current treatment were collected through questionnaires at enrollment (T1). Pretreatment lateral cephalograms and intraoral frontal photographs were submitted. Treatment performed, and details related to treatment outcome were recorded through questionnaires at the end of active treatment (T2). Posttreatment lateral cephalograms and intraoral frontal photographs were submitted. Patient satisfaction at T2 was assessed using a 5-point Likert-type scale and open-ended responses. Predictive univariate models were developed to evaluate the factors that affect patient satisfaction. Open-ended responses were reviewed for general trends.ResultsT2 data were received for 260 patients, and 248 of these patients completed and returned the patient satisfaction questionnaires. High levels of satisfaction were found in this sample of adult patients receiving treatment for anterior open bite malocclusion. Specifically, 96% of the sample reported being very or somewhat satisfied. Only 10 patients (4%) were not satisfied with the treatment provided or an element of the final result. Successful open bite closure, treatment modality, and certain patient characteristics may affect patient satisfaction. However, there was insufficient power to demonstrate statistical significance because of the very low number of dissatisfied patients. Open-ended responses directly associated with patient satisfaction were received from 23 patients (9%). They relayed positive, neutral, and negative feelings about the treatment received and final results. Additional responses regarding the orthodontic treatment in general, but not specifically linked to patient satisfaction, were received from 119 patients (48%). These comments depict an overwhelmingly positive experience.ConclusionsAdult patients who received orthodontic treatment for anterior open bite malocclusion were generally satisfied with the treatment provided, as well as the final esthetic and functional results.

Dataset Information

Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial.

Publications

Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial.

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