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Aliaga-Del Castillo A, Marañón-Vásquez GA, Janson G, Vilanova L, Miranda F, Massaro C, Bellini-Pereira SA, Arriola-Guillén LE, Yatabe M, Ruellas AC, Cevidanes L, Garib D. Oral health-related quality of life, adaptation/discomfort during open bite treatment with spurs: complementary analysis from a randomized clinical trial. Sci Rep 2024; 14:5732. [PMID: 38459254 PMCID: PMC10923863 DOI: 10.1038/s41598-024-56363-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
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 (CPQ8-10) 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.
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Affiliation(s)
- Aron Aliaga-Del Castillo
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Guido Artemio Marañón-Vásquez
- Department of Orthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, 17012901, Brazil
| | - Lorena Vilanova
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, 17012901, Brazil
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, 17012901, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, 17012901, Brazil
| | | | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, 15067, Lima, Peru
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Antonio Carlos Ruellas
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, 21941901, Brazil
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, 17012901, Brazil
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, 17012900, Brazil
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Elshal NS, Mohammad MH, Tawfik MA, Fouda MAES. Dentoalveolar effects of skeletally anchored extrusion arch in anterior open bite patients: A prospective clinical trial. Dental Press J Orthod 2024; 28:e2323110. [PMID: 38198349 PMCID: PMC10768647 DOI: 10.1590/2177-6709.28.6.e2323110.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/18/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE The purpose of this prospective clinical trial was to explore the dental and soft tissue changes accompanying the use of skeletally anchored nickel-titanium (NiTi) extrusion arch in the correction of anterior open bite (AOB). MATERIAL AND METHODS Twenty female patients with a mean age of 16.5 ± 1.5 years and a mean dentoalveolar AOB of 2.38±0.7 mm participated in this study. All patients were treated with an maxillary 0.017×0.025-in NiTi extrusion arch, with the aid of miniscrews inserted between the maxillary second premolars and first molars bilaterally, to act as indirect anchorage. Three-dimensional digital models and lateral cephalometric radiographs were taken just before the insertion of the extrusion arch (T0) and after 10 months (T1). Paired-sample t-tests were used in analyzing the data, to evaluate the changes after treatment (T1-T0). A significance level of p < 0.05 was used. RESULTS AOB was successfully closed in all patients, with a 4.35 ± 0.61 mm increase in the overbite. Maxillary incisors significantly extruded (2.52 ± 1.02 mm) and significantly reclined (5.78 ± 0.77°), with a resultant decrease in the overjet of 1.58 ± 0.5mm. A significant intrusion of maxillary first molars with no change in their inclination was observed. The upper lip showed a significant retraction tendency to the E-plane, and a significant increase in the nasolabial angle was observed. CONCLUSION The skeletally anchored NiTi extrusion arch was an effective technique in treating AOB, with no adverse effects on the molars.
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Affiliation(s)
- Noheir Samir Elshal
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
| | | | - Marwa Ali Tawfik
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
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Meng M, Xie Y, Cao J, Yu Y, Zhou X, Zou J. Effects of bonded spurs, fixed and removable palatal crib in the early treatment of anterior open bite: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 163:298-310. [PMID: 36564317 DOI: 10.1016/j.ajodo.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Bonded spurs, fixed or removable palatal cribs have been used to treat anterior open bite (AOB) in growing children. Different conclusions have been brought out by different authors. This meta-analysis aimed to evaluate the effect of bonded spurs, fixed and removable palatal cribs in the early treatment of AOB. METHODS A comprehensive electronic search was carried out through PubMed, Embase (via Ovid), MEDLINE (via Ovid), Cochrane Central Register of Controlled Trials, and Web of Science up to May 1, 2022. This meta-analysis was performed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The work was carried out by 2 reviewers in duplicate and independently, including electronic searching, data extracting, risk of bias assessment, quality of evidence grading, heterogeneity and statistical power analysis, and eligibility evaluation of the retrieved articles. RESULTS Four studies out of 181 articles were recruited in the meta-analysis after applying the inclusion and exclusion criteria. The results showed that bonded lingual spurs and fixed palatal crib or spurs produced similar overbite changes (mean difference, -0.32; 95% confidence interval, -1.06 to 0.43; P = 0.41; I2 = 27%; meta power = 0.099). Fixed palatal crib and removable palatal crib also exhibited comparable effects in correcting AOB (mean difference, -0.02; 95% confidence interval, -0.90 to 0.86; P = 0.96; I2 = 0%; meta power = 0.2182). The quality of evidence about these 2 outcomes assessed with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was low. CONCLUSIONS Bonded lingual spurs, fixed palatal crib or spurs, and removable palatal crib had similar effects in the early treatment of AOB. Because the number of included studies was limited and only the overbite changes before and after treatment were assessed, more clinical randomized controlled studies with longer follow-ups are needed to get more clinically significant advice.
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Affiliation(s)
- Mingmei Meng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yongting Xie
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingwei Cao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Yu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Jing Zou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Three-dimensional dentoalveolar changes in open bite treatment in mixed dentition, spurs/posterior build-ups versus spurs alone: 1-year follow-up randomized clinical trial. Sci Rep 2022; 12:12378. [PMID: 35858941 PMCID: PMC9300740 DOI: 10.1038/s41598-022-15988-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 07/04/2022] [Indexed: 11/12/2022] Open
Abstract
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.
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Fouda AS, Afify AK, Aboulfotouh MH, Attia KH, Abouelezz AM, Elkordy SA. Dental arch changes after anterior open bite treatment in the mixed dentition produced by miniscrew-supported palatal crib vs conventional fixed palatal crib. Angle Orthod 2022; 92:487-496. [PMID: 35130348 DOI: 10.2319/082321-659.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the dental arch changes produced by the miniscrew-supported palatal crib (MSPC) and the conventional fixed palatal crib (CFPC) after the treatment of patients with anterior open bite (AOB) attributed to the tongue-thrusting habit in the mixed dentition stage. MATERIALS AND METHODS A total of 26 children aged 8 to 11 years with an AOB were randomly distributed into two equal groups; the MSPC group was treated using a palatal crib supported by two miniscrews inserted paramedially, whereas the CFPC group was treated using a conventional fixed palatal crib soldered to bands. Digital models were obtained pretreatment and after a follow-up duration of 9 months. RESULTS The MSPC group included 12 participants (9 girls and 3 boys; mean age, 9.4 ± 0.75 years), and the CFPC group included 12 participants (10 girls and 2 boys; mean age, 9.0 ± 0.73 years). The amount of AOB closure was similar in both groups: 3.97 ± 1.44 mm in the MSPC group and 3.97 ± 0.89 mm in the CFPC group. There was significant mesial movement of the maxillary first molar in the CFPC (-1.42 ± 0.99 mm) compared with the MSPC group (-0.53 ± 0.32 mm). CONCLUSIONS Both appliances resulted in similar improvement in the amount of AOB closure. There was significantly more mesial movement of the maxillary first molars in the CFPC group compared with the MSPC group.
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