Craniomandibular transverse tomographic evaluation after anterior open bite orthodontic treatment with miniplates anchorage.

BACKGROUND: Skeletal anterior open bite (SAOB) represents one of the most complex and challenging malocclusions in orthodontics. Orthodontic treatment supported by miniplates enable to reduce the need for orthognathic surgery. Transverse dimension may be affected by intrusion biomechanics. This study aims to assess transverse bone alterations in patients with SAOB who underwent orthodontic treatment with absolute anchorage using four miniplates. METHODS: A total of 32 patients of both sexes, with an average age of 33.8 years, diagnosed with SAOB and treated orthodontically with four miniplates (one in each hemiarch), were selected for this study. Tomographic examinations were performed before (T1) and after (T2) orthodontic treatment. Linear measurements (width of the maxillary base, maxillary alveolar, maxillary root, maxillary dental cusp, mandibular alveolar) and angular measurements (maxillary intermolar angle) were assessed in these images. The Shapiro-Wilks normality tests were applied to verify data distribution, and the paired t-test was used to compare the initial and final measures obtained. RESULTS: Among the evaluated parameters, the maxillary alveolar width, maxillary dental cusp width, mandibular alveolar cusp width, and intermolar angle showed statistically significant differences between T1 and T2 (p < 0.05). However, maxillary base and maxillary root widths showed no significant difference (p > 0.05). CONCLUSIONS: Intrusion and distalization with miniplates in SAOB therapy may lead to significant expansive changes, due to molars cusps width and buccal inclination increase restricted at the alveolar level.

Comparison of mesiodistal angulations of premolars and molars in anterior open bite subjects with different sagittal malocclusions: A retrospective study.

INTRODUCTION: Mesiodistal angulation of premolars and molars can be altered by forces of open bite malocclusion. The aim of this study was to compare the mesiodistal angulations of the posterior teeth in class I, II, and III individuals with anterior open bite (AOB) versus individuals with harmonious occlusion. METHODS: This comparative cross-sectional study used 299 lateral head radiographs of individuals with permanent dentition. There were 4 groups (harmonious occlusion [n=89], Class I open bite [OB] [n=75], Class II OB [n=66], and Class III OB [n=69]). Premolar (1UPM, 2UPM) and molar (1UM, 2UM) angulations were measured relative to the occlusal plane and the palatal or mandibular plane by a trained and calibrated evaluator. ANOVA and Scheffe tests were used for statistical analyses (P<0.05). RESULTS: The mesial angulation of the upper premolars showed greater angulation of between approximately 2° and 5° in the OB groups compared to the harmonious occlusion group (P<0.05). Only in the Class II OB group did the first and second upper molars show distal angulation in relation to the palatal plane (1UM 81.85°±5.42°; 2UM 75.32±7.4°) (P<0.05). The Class III OB group presented the greatest distal angulations of the lower premolars and molars (between 3° to 5° of difference, P<0.05) in relation to those of the harmonious occlusion group. CONCLUSIONS: The upper first premolars in all the AOB groups and the lower second premolars in the Class II OB group had greater mesioangulation. Additionally, the upper molars of the Class II OB group and the lower molars of the Class III OB group showed distoangulation compared with the molars in the group with harmonious occlusion.

Influence of rapid maxillary expansion in the stability of anterior open bite treatment.

OBJECTIVES: This study aimed to compare the stability of anterior open bite (AOB) in patients treated with and without rapid maxillary expansion (RME) before fixed palatal crib (PC) therapy in the mixed dentition. MATERIAL AND METHODS: Expansion/palatal crib group (EPC) was comprised of 25 patients (10 male, 15 female, mean initial age of 7.8 years) with AOB treated with RME before PC therapy. Palatal crib group (PC) included 25 patients with AOB (10 male, 15 female, mean initial age of 8.0 years) treated only with PC therapy. Lateral cephalograms were analyzed at pre-treatment (T0), after PC therapy (T1), and 3 years after PC removal (T2) in both groups. AOB relapse was considered when a negative overbite was observed at T2. Intergroup comparisons of interphase changes were performed using t and Mann-Whitney tests (p < 0.05). RESULTS: Treatment and post-treatment alterations showed similar changes in both groups for all cephalometric variables. Overall changes from T0 to T2 were similar between the groups except for the maxillary incisors that tipped lingually in PC group (1.PP = - 3.37°) and labially in EPC group (1.PP = 1.76°). The frequency of AOB relapse was 8% and 4% in the EPC and PC groups, respectively. Treatment time in the EPC group (9.7 months) was shorter (p = 0.024) when compared to the PC group (11.0 months). CONCLUSIONS: In the mixed dentition, stability of AOB treated with RME before fixed PC therapy was similar to PC therapy alone. However, treatment time with fixed PC was slightly shorter in the group treated with RME. CLINICAL RELEVANCE: This study aims to understand if RME performed previously to fixed palatal crib contributes to the index of stability of AOB treatment in the mixed dentition.

A Recurrent FAM83H Mutation in an Extended Colombian Family and Variable Craniofacial Phenotypes.

Amelogenesis imperfecta (AI) is a collection of rare genetic disorders affecting the quantity and/or quality of the tooth enamel. AI can be classified into three major types according to the clinical phenotype: hypoplastic, hypocalcified, and hypomatured. Among them, the hypocalcified type shows the weakest physical properties, leaving rough and discolored enamel surfaces after tooth eruption. To date, mutations in the FAM83H gene are responsible for the autosomal-dominant hypocalcified AI. In this study, we recruited a four-generation Colombian family with hypocalcified AI and identified a recurrent nonsense mutation in the FAM83H gene (NM_198488.5:c.1289C>A, p.(Ser430 *)) by candidate gene sequencing. Cephalometric analyses revealed the anterior open bite that occurred in the proband is not correlated with the AI in this family.

Interceptação da mordida aberta anterior na dentição mista ­ relato de caso / Anterior open bite interception in mixed dentition ­ case report

Resumo A mordida aberta anterior (MAA) merece destaque ímpar, já que além de ser a mais frequente entre as discrepâncias verticais e comprometer a estética dental, interfere também na função mastigatória e na fala do paciente, afetando consequentemente a sua auto-estima. Por seu caráter multifatorial, essa má oclusão pode ser causada por diversas razões, tais como a herança genética ou desenvolvimento maxilofacial inerente a cada individuo. O presente trabalho teve como objetivo descrever o tratamento de um paciente com MAA. O paciente BS de 7 anos e 5 meses de idade possuía má oclusão de Classe I com mordida aberta anterior (-2,8 mm). O plano de tratamento foi dividido em duas fases: na primeira, foi utilizado o aparelho de Haas com grade lingual na arcada superior; na arcada inferior, utilizou-se um expansor removível. Na sequência do tratamento, instalou-se o aparelho fixo em ambas as arcadas. O tratamento teve duração de 9 (nove) meses e conseguiu o fechamento da mordida aberta anterior. A segunda fase iniciou-se após a irrupção dos segundos molares permanentes e teve duração de 13 meses. Como conclusão se observou que o tratamento da mordida aberta anterior em duas fases foi uma excelente escolha para o tratamento do paciente aqui relatado. Na primeira fase, a mordida foi fechada e as arcadas foram alargadas para permitir o posicionamento adequado de todos os dentes permanentes, que tiveram seu posicionamento perfeitamente detalhado na segunda fase.(AU)

Abstract The anterior open bite (AOB) deserves unique attention as in addition to being the most frequent among vertical discrepancies and compromising dental aesthetics, it interferes in the patient chewing function and speech, consequently affecting their self-esteem. Due to its multifactorial character, this malocclusion can be caused by several reasons, such as genetic inheritance or maxillofacial development inherent to each individual. This study aimed to describe the treatment of a patient with AOB. Patient BS 7-year and 5-month-old had a Class I malocclusion with anterior open bite (-2.8 mm). The treatment plan was divided into two phases: In the first, the Haas appliance with fixed palatine crib in the upper arch was used; in the lower arch, a removable expander was used. Following the treatment, the fixed appliance was installed in both arches. The treatment lasted 9 months and achieved AOB closure. The second phase started after the eruption of the second permanent molars and lasted 13 months. In conclusion, it was observed that the treatment of AOB in two phases was an excellent choice for the patient treatment reported here. In the first phase, the bite was closed, and the arches were widened to allow the proper positioning of all the permanent teeth, which had their positioning perfectly detailed in the second phase.(AU)

Pathways to anterior open bite after changing of pacifier sucking habit in preschool children: A cohort study.

BACKGROUND: Pacifier use is a major cause of anterior open bite (AOB), which negatively impacts the quality of life of children affected. AIM: To assess the direct and indirect pathways related to pacifier sucking habit and AOB in preschool children. DESIGN: This 2-year cohort study evaluated a random sample of preschool children (2-5 years of age) from Southern Brazil. Caregivers answered a questionnaire addressing socio-economic and behavioural characteristics. Anterior open bite was recorded following the criteria recommended by Foster and Hamilton. Structural equation model was performed to assess the direct and indirect pathways among variables at baseline (T1) to predict the AOB at follow-up (T2). RESULTS: Regarding the AOB, 407 children were evaluated at T1 and 187 at T2. The prevalence of AOB was 32.9% at baseline and 16.0% at follow-up. The presence of AOB at follow-up was directly affected by the change in pacifier sucking habit from T1 to T2. Considering the indirect paths, the AOB at T1 influenced the AOB in T2 via a change of pacifier sucking habit. CONCLUSION: These findings suggest that the non-habit of sucking pacifiers is a fundamental strategy for the prevention of AOB as well as the promotion of health in childhood.

Abordagem precoce da má oclusão de Classe II esquelética com atresia maxilar e mordida aberta anterior e o uso de alinhadores ClearCorrect ­ relato de caso / Early approach to skeletal Class II malocclusion with maxillary atresia and anterior open bite and the use of ClearCorrect aligners ­ case report

Resumo O adequado planejamento e o tratamento precoce da má oclusão de Classe II de Angle, com atresia maxilar e mordida aberta anterior, proporciona a harmonização das bases ósseas maxilo-mandibulares nos três planos do espaço. Os alinhadores ortodônticos surgiram como uma alternativa de tratamento, tendo como vantagens: serem mais estéticos e mais confortáveis para o paciente, permitirem menor tempo de tratamento, quando corretamente indicados, menor tempo de cadeira, menos intercorrências, possibilidade de monitoramento à distância, maior facilidade de alimentação e higienização dentária. Por outro lado, apresentam dificuldades em tratamentos de adultos com más oclusões severas de Classe II esquelética, de mordida cruzada posterior e de mordida aberta anterior. Portanto se objetiva com esse relato de caso clínico corrigir precocemente a má oclusão de Classe II esquelética com atresia maxilar, por meio do uso de ortopedia mecânica e dispositivos que auxiliam na eliminação de hábitos e fechamento da mordida aberta anterior e, posteriormente, a utilização de alinhadores ortodônticos para a finalização do tratamento. Concluiu-se que o tratamento interceptativo precoce da má oclusão foi eficiente para a harmonização entre as bases ósseas nos sentidos ântero-posterior, vertical e transversal, transformando essa má oclusão de alta para baixa complexidade e, consequentemente, altamente previsível e com excelente prognóstico para o tratamento com alinhadores ortodônticos. O tratamento com os alinhadores ClearCorrect corrigiu a oclusão em um curto período de tempo, quando comparado com Ortodontia corretiva e com uma alta previsibilidade em relação ao setup virtual. (AU)

Abstract Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high (AU)

Anclaje esquelético para el tratamiento de las anomalías de clase II y mordida abierta anterior: informe de un caso / Skeletal anchorage for the treatment of class II anomalies and anterior open bite: report of a case

El reporte de este caso tiene como objetivo demostrar la utilidad de los anclajes esqueléticos temporarios como son las miniplacas cigomáticas y los microimplantes "buccal shelf" en el tratamiento ortodóncico, en una paciente de 17 años 10 meses de edad, clase II vertical, dólicofacial, con mordida abierta anterior y aumento de la altura facial inferior. Después de la primera fase de tratamiento, siguiendo la secuencia de arcos para completar la alineación, se utilizaron anclajes esqueléticos extrarradiculares con una mecánica de intrusión con fuerzas elásticas durante 10 meses. Se intruyeron sus piezas posteriores superiores e inferiores y se distalizó la arcada superior, corrigiéndose la oclusión. El mentón retrognático y su perfil convexo mejoraron con la autorrotación de la mandíbula (AU)

The objective of this report case is to demonstrate the usefulness of temporary skeletal anchors such as zygomatic miniplates and buccal shelf microimplants in orthodontic treatment, in a 17-year-old 10-month-old, vertical class II, dollicofacial patient with anterior open bite and increased lower facial height. After the first treatment phase, following the arch sequence to complete the alignment, extra-radicular skeletal anchors were used with intrusion mechanics with elastic forces for 10 months. Its upper and lower posterior pieces were intruded and the upper arch was distalized, correcting the occlusion. e retrognathic chin and its convex profile improved with autorotation of the jaw (AU)

Treatment of adult patient with hyperdivergent retrognathic phenotype and anterior open bite: report of a case with non-surgical orthodontic approach

ABSTRACT Adult patients with anterior open bite and hyperdivergent retrognathic phenotype demand complex treatments, as premolar extractions, molar intrusion or orthognathic surgery. In the present clinical case, a young adult patient without significant growth, with Class I and anterior open bite, was treated with four premolar extractions. The therapeutic result shows good intercuspation, good facial esthetic, good function balance, and stability in a two-year post-fixed treatment follow-up.

RESUMO Pacientes adultos com mordida aberta anterior e fenótipo hiperdivergente retrognata demandam tratamentos complexos, com extrações de pré-molares, intrusão de molares ou cirurgia ortognática. No presente caso clínico, uma jovem adulta sem potencial significativo de crescimento, apresentando Classe I e mordida aberta anterior, foi tratada com extrações de quatro primeiros pré-molares. O resultado terapêutico alcançou boa intercuspidação, boa estética facial e bom equilíbrio funcional, e mostrou-se estável depois de dois anos da remoção do aparelho fixo.

Negligible tooth resorptions after anterior open bite treatment using skeletal anchorage with miniplates

ABSTRACT Introduction: When miniplates are used as anchoring for orthodontic mechanics for anterior open bite correction by retraction of anterior teeth and posterior teeth intrusion and retraction, orthodontically induced inflammatory external apical root resorption is clinically negligible. Methods: A homogeneous sample of 32 patients was used, and the roots of the teeth were compared on CT scans performed before and after orthodontic treatment. Results: The observed root resorption was minimal, and this can be explained by the uniform distribution of forces in several teeth, simultaneously, in the set of the dental arch and in the bone that supports the teeth. Conclusion: The most important thing to prevent root resorption in orthodontic practice, besides being concerned with the intensity of the applied forces, is to be careful with its distribution along the roots of each tooth, in the dental arch and in the bone that supports the teeth.

RESUMO Introdução: Quando são utilizadas miniplacas como ancoragem para a mecânica ortodôntica de correção da mordida aberta anterior por meio da retração dos dentes anteriores e intrusão e retração dos dentes posteriores, as reabsorções radiculares apicais externas inflamatórias induzidas ortodonticamente são clinicamente irrelevantes. Métodos: Usou-se uma amostra homogênea de 32 pacientes, e comparou-se as raízes dos dentes em tomografias realizadas antes e depois do tratamento ortodôntico. Resultados: As reabsorções radiculares observadas foram mínimas, e isso pode ser explicado pela distribuição uniforme das forças em vários dentes, simultaneamente, no conjunto da arcada dentária e no osso que suporta os dentes. Conclusão: O mais importante para se prevenir as reabsorções radiculares na prática ortodôntica, além de se preocupar com a intensidade das forças aplicadas, é tomar cuidado com a sua distribuição ao longo das raízes de cada dente, na arcada dentária e no osso que suporta os dentes.

Influence of pacifier use on the association between duration of breastfeeding and anterior open bite in primary dentition.

BACKGROUND: The literature is controversial with regard to the association between longer breastfeeding duration and lower prevalence of anterior open bite. Pacifier use may be involved in this controversy. Thus, the objective of the study was to assess the influence of pacifier use and its duration on the association between longer breastfeeding duration and lower prevalence of anterior open bite in children with primary dentition. METHODS: This was a cross-sectional study nested in a cohort study involving 153 infants recruited at a maternity hospital in the municipality of Porto Alegre, southern Brazil. The study outcome (anterior open bite) was assessed when the children were between 3 and 5 years old. Data on breastfeeding and pacifier use were collected at 7, 30, 60, 120, and 180 days of life and on the date of the evaluation here described. Poisson regression with robust variance was used to analyze the association between the prevalence of anterior open bite and breastfeeding duration, expressed in months. RESULTS: The univariate analysis showed a protective effect of breastfeeding against anterior open bite (prevalence ratio [PR] 0.96; 95% confidence interval [95%CI] 0.95-0.98). This effect remained significant after adjustment for pacifier use at any time between birth and the date of dental assessment (PR0.98; 95%CI; 0.96-0.99), i.e., there was a reduction of 2% in the prevalence of anterior open bite for each month of breastfeeding. However, this effect lost significance when pacifier use duration was included in the multivariate analysis (PR1.00; 95%CI; 0.99-1.01). CONCLUSIONS: Pacifier use duration influences the association between longer breastfeeding duration and lower prevalence of anterior open bite. It is likely that prolonged pacifier use reduces the magnitude of this association.

Brain Cortex Activity in Children With Anterior Open Bite: A Pilot Study.

Anterior open bite (AOB) is related to functional alterations of the stomatognathic system. There are no studies concerning brain activation of the cortex comparing children with and without AOB during rest and activities such as deglutition and phonation. The aim of this study was to determine the activity of the brain cortex of children with AOB at rest and during phonation and deglutition and to evaluate the association of intelligence quotient (IQ), attention (Test of Variables of Attention, known as TOVA), beats per minute (BPM), and oxygen saturation measurement (SpO2) with brain activity in subjects with AOB. Fourteen children (seven with AOB and seven without AOB) with mixed dentition, aged 10-13 years, underwent an IQ test, TOVA, SpO2, and quantitative electroencephalography (QEEG). Electrodes were set in the scalp, according to the 10-20 protocol. Data were analyzed using statistical tests to assess comparisons between children with and without AOB. The results showed that IQ, TOVA, SpO2, or BPM did not show any statistically significant differences between the groups, except for the response time (contained in TOVA) (p = 0.03). Significant differences were found for the brain activity during rest (Condition 1) of the tongue, between children with and without AOB (p < 0.05 for alpha/theta and alpha peaks), whereas there were no differences during function (Condition 2). The findings of this investigation provide insights about the cortex activity of the brain while the tongue is in the resting position in children with AOB. This may imply an altered activity of the brain cortex, which should be considered when diagnosing and treating AOB. Other diagnostic techniques derived from investigations based on neuroscience could develop new diagnostic and therapeutic techniques to give better solutions to children with malocclusions. Treatments should be focused not only on the teeth but also on the brain cortex.

Tratamento ortodôntico cirúrgico de mordida aberta anterior ­ relato de caso / Surgical-orthodontic treatment of anterior open bite ­ case report

Resumo A mordida aberta anterior faz parte das más oclusões verticais e é definida como a presença de um trespasse vertical negativo entre as bordas incisais dos dentes anteriores superiores e inferiores, resultando em um maior comprometimento estético e funcional. É uma má oclusão difícil de ser tratada e de estabilidade duvidosa. Sua etiologia é multifatorial e ocorre por dois principais motivos que são a hereditariedade ou causas ambientais. A mordida aberta anterior é classificada em duas categorias: dentária e esquelética. Em casos em que há um maior envolvimento de componentes esqueléticos é necessário associar a cirurgia ortognática ao tratamento ortodôntico. Este artigo tem como objetivo detalhar o tratamento de mordida aberta anterior esquelética de uma paciente tratada com ortodontia associada à cirurgia ortognática envolvendo apenas a mandíbula, com rotação anti-horária da mesma. Os resultados demonstraram que após o preparo ortodôntico e a realização da cirurgia ortognática, a paciente apresentou uma relação molar e de caninos de Classe I, melhora do perfil, diminuição do padrão vertical e obtenção de selamento labial passivo. O correto diagnóstico é fundamental para que se possa optar pelo tratamento que gere bons resultados e satisfação do paciente, sempre levando em consideração o grau de severidade da má oclusão. (AU)

Abstract Anterior open bite is part of vertical malocclusions and is defined as the presence of a negative overbite between the incisal edges of the maxillary and mandibular anterior teeth, resulting in greater aesthetic and functional impairment. It is a malocclusion that is difficult to treat and of doubtful stability. Its etiology is multifactorial and occurs for two main reasons which are heredity or environmental causes. Anterior open bite is classified into two categories: dental and skeletal. In cases in which there is greater involvement of skeletal components, it is necessary to associate orthognathic surgery with orthodontic treatment. This article aims to detail the treatment of skeletal anterior open bite of a patient treated with orthodontics associated with orthognathic surgery involving only the mandible, with its counterclockwise rotation. The results showed that after orthodontic preparation and orthognathic surgery, the patient presented a Class I molar and canine relationship, improved profile, decreased vertical pattern and passive lip sealing. The correct diagnosis is essential to choose the treatment that generates good results and patient satisfaction, always considering malocclusion severity. (AU)

Perfil do aleitamento e a ocorrência de má oclusão em crianças participantes da bebê-clínica / Breastfeeding profile and the occurrence of malocclusion in children participating at Baby Clinic

Essa pesquisa trata-se de uma análise transversal do perfil do aleitamento de crianças que frequentam a Bebê Clínica, um Programa Educativo/Preventivo em Saúde Bucal, e a ocorrência de oclusopatias. O objetivo foi analisar a influência do perfil do aleitamento sobre a condição oclusal de crianças que participam de um programa odontológico educativo-preventivo. Participaram da pesquisa 400 crianças entre 27 e 48 meses, sendo 200 que frequentam a Bebê-Clínica e 200 de escolas do município de Araçatuba, não participantes da Bebê-Clínica, Esta pesquisa constou da coleta de informações retrospectivas sobre o tempo, o tipo e a forma de aleitamento, além dos hábitos de sucção não nutritiva, por meio de um questionário realizado com as mães. Foi realizada também uma avaliação clínica da oclusão dentária dessas crianças, utilizando o índice de má oclusão preconizado pela OMS. Os dados foram analisados pelo teste do qui-quadrado. Os resultados indicaram em ambos os grupos uma elevada porcentagem de mães que amamentaram seus filhos (acima de 84%); elevada porcentagem de crianças com hábitos de sucção não nutritiva (acima de 57%) e um elevado índice de má oclusão dentária, sendo a principal, a mordida aberta anterior. Considerando os aspectos estudados nesta pesquisa, verificamos que ambos os grupos apresentaram resultados semelhantes, portanto não havendo influência da participação no programa da Bebê-Clínica(AU)

This research deals with a cross-sectional analysis of the breastfeeding profile that is frequent in the Baby Clinic, in an Educational / Preventive Oral Health Program, and an occurrence of occlusions. The objective was to analyze the influence of the breastfeeding profile on the occlusal condition of children who participate in an educational-preventive dental program. Participated in the research 400 children between 27 and 48 months, 200 of them attending the Baby Clinic and 200 from schools in the city of Araçatuba, not participating in the Baby Clinic. This research consisted of collecting retrospective information about time, type and form of breastfeeding, and non-nutritive sucking habits, through a questionnaire conducted with mothers. A clinical evaluation of the dental occlusion of these children was also performed, using the malocclusion index recommended by WHO. Data were analyzed by chi-square test.The results indicated in both groups a high percentage of mothers who breastfed their children (over 84%); high percentage of children with non-nutritive sucking habits (above 57%) and a high rate of dental malocclusion, the main one being the anterior open bite.Considering the aspects studied in this research, we found that both groups presented similar results, therefore there was no influence of participation in the program of the Baby Clinic(AU)

Stability of early treatment of anterior open bite: clinical performance of bonded lingual spurs.

Anterior open bite (AOB) is a malocclusion that generates aesthetic, speech, feeding and psychological issues, a fact that emphasises the importance of conducting early treatments to fix the disorder. Finger-sucking, pacifiers and oral habits are the main aetiological factors of AOB; thus, it is necessary to apply interceptive treatments focused on correcting and improving bite stability during childhood in order prevent the need of undergoing advanced therapy. The aim of this article is to present the early diagnosis of aetiological factors causing severe AOB and the interceptive treatment based on the use of bonded lingual spurs for one year. Results showed excellent bite stability after two years of follow-up; in other words, the proper treatment applied for the recommended growth and developmental periods enabled case stability.

Association between occlusal characteristics and the occurrence of dental trauma in preschool children: a case-control study.

BACKGROUND/AIMS: Occlusal features may increase the risk of dental trauma. The aim of the present study was to evaluate the association between occlusal characteristics and the occurrence of dental trauma in preschool children. MATERIALS AND METHODS: A population-based case-control study was conducted with a representative sample of 200 children 3-5 years of age enrolled at private and public preschools in the city of Diamantina, Brazil. The case and control groups were matched for gender, age and type of preschool (public or private) at a ratio of 1:1 (100 cases and 100 controls). Independent variables of interest to the study (occlusal characteristics) and potential confounders (sociodemographic characteristics, sucking habits and lip coverage) were investigated. Intra-examiner and inter-examiner kappa values were higher than 0.80 for all oral conditions evaluated. The SPSS 22.0 program was used to analyse the data. Descriptive and univariate analyses as well as simple and multiple logistic regression analyses were performed. RESULTS: The occlusal feature most strongly associated with trauma was anterior open bite (OR = 3.80; 95% CI: 1.42-10.16). Maxillary anterior crowding (OR = 2.14, 95% CI: 1.00-4.63) and overjet (OR = 1.12, 95% CI: 0.58-2.17) were associated with the occurrence of trauma independently of the confounding variables (sociodemographic characteristics, sucking habits and lip coverage), but these variables lost their significance when adjusted for other types of malocclusion. Anterior open bite remained strongly associated with dental trauma, regardless of confounding variables and other types of malocclusion. CONCLUSION: Anterior open bite was the main variable associated with dental trauma in the preschool children analysed independently of the confounding variables and the presence of other malocclusions.

Three-dimensional assessment of external apical root resorption after maxillary posterior teeth intrusion with miniscrews in anterior open bite patients

ABSTRACT Objective: The objective of this study was to assess the external apical root resorption (EARR) of the maxillary posterior teeth after intrusion with miniscrews. Methods: Fifteen patients (13 females and 2 males) with age ranging from 14.5 to 22 years (mean 18.1 ±2.03 years) were selected to participate in this study. All patients presented with anterior open bite of 3 mm or more. An intrusion force of 300 g was applied on each side to intrude the maxillary posterior teeth. Cone beam computed tomography (CBCT) scans were taken pretreatment and post-intrusion and were analyzed to evaluate the EARR. Results: The maxillary posterior teeth were intruded in average 2.79 ± 0.46 mm (p< 0.001) in 5.1 ± 1.3 months, and all examined roots showed statistically significant EARR (p< 0.05) with an average of 0.55 mm, except the distobuccal root of the left first permanent molars and both the palatal and buccal roots of left first premolars, which showed no statistically significant changes. Conclusions: The evaluated teeth presented statistically significant EARR, but clinically, due to the small magnitude, it was not considered significant. Moreover, the CBCT provided a good visualization of all roots in all three planes, and it was effective in detecting minimal degrees of EARR.

RESUMO Objetivo: o objetivo desse estudo foi verificar a existência de reabsorção radicular apical externa (RRAE) em dentes posterossuperiores após intrusão ancorada em mini-implantes. Métodos: quinze pacientes (13 mulheres e 2 homens) com a idade variando entre 14,5 e 22 anos (média de 18,1 ± 2,03 anos) foram selecionados para participar desse estudo. Todos os pacientes possuíam mordida aberta anterior de 3mm ou mais. Uma força de 300 gramas foi aplicada em cada lado para intruir os dentes posterossuperiores. Tomografias computadorizadas de feixe cônico (TCFC), adquiridas antes do tratamento e após a intrusão, foram comparadas para se avaliar a RRAE. Resultados: os dentes posterossuperiores foram intruídos em média 2,70 ± 0,46 mm (p< 0,001) em 5,1 ± 1,3 meses, e todas as raízes examinadas mostraram RRAE estatisticamente significativa (p< 0,05), com média de 0,55 mm, exceto pela raiz distovestibular dos primeiros molares permanentes esquerdos, e pelas raízes palatina e vestibular dos primeiros pré-molares esquerdos, que não apresentaram mudanças estatisticamente significativas. Conclusões: os dentes avaliados apresentaram RRAE estatisticamente significativa, a qual, porém, não foi considerada clinicamente significativa, devido à sua reduzida magnitude. Além disso, a TCFC possibilitou uma boa visualização de todas as raízes nos três planos espaciais, e foi eficaz para detecção de níveis mínimos de RRAE.

Genetic Polymorphism in MMP9 May Be Associated With Anterior Open Bite in Children

Abstract Anterior open bite (AOB) has a multifactorial etiology caused by the interaction of sucking habits and genetic factors. The aim of this study was to evaluate the association between AOB and polymorphisms in genes that encode Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). Four hundred and seventy-two children that presented at least one sucking habit were evaluated. Children were examined clinically for the presence of AOB. Genomic DNA was extracted from saliva. Genotyping of the selected polymorphisms in MMP2, MMP3, MMP9, TIMP1 and TIMP2 was carried out by real-time PCR using the TaqMan method. Allele and genotype frequencies were compared between the groups with and without AOB using the PLINK® software in a free and in a recessive model using a chi-square test. Logistic regression analysis was implemented (p≤0.05). Two hundred nineteen children had AOB while 253 did not. The polymorphism rs17576 in MMP9 was significantly associated with AOB (p=0.009). In a recessive model GG genotype was a protective factor for AOB (p=0.014; OR 4.6, 95%CI 1.3-16.2). In the logistic regression analysis, none of the genes was associated with AOB. In conclusion, the polymorphism rs17576 (glutamine for arginine substitution) in MMP9 was a protective factor for AOB.

Resumo A mordida aberta anterior apresenta uma etiologia multifatorial causada pela interação entre hábitos de sucção e fatores genéticos. O objetivo deste estudo foi avaliar a associação entre mordida aberta anterior e polimorfismo nos genes que codificam as metaloproteinases da matriz (MMPs) e seus inibidores teciduais (TIMPs). Foram avaliadas 472 crianças que apresentvam pelo menos um hábito de sucção. As crianças foram clinicamente examinadas para avaliar a presença de mordida aberta anterior. DNA genômico foi extraído da saliva. A genotipagem dos polimorfismos selecionados em MMP2, MMP3, MMP9, TIMP1 e TIMP2 foi realizada por PCR em tempo real, usando o método de TaqMan. As frequências alélicas e genotípicas foram comparadas entre os grupos com e sem mordida aberta anterior usando o software PLINK®. Duzentas e dezenove crianças apresentavam mordida aberta anterior enquanto 253 não a apresentavam. O polimorfismo rs17576 em MMP9 estava significativamente associado com mordida aberta anterior (p=0,009). No modelo recessivo (GG versus AG+AA) o genótipo GG foi um fator protetor para mordida aberta anterior (p=0,014; OR 4,6; 95%CI 1,3- 16,2). Concluindo, o polimorfismo rs17576 (substituição de glutamina por arginina) em MMP9 está associado com mordida aberta anterior. Os resultados obtidos suportam a hipótese de que fatores genéticos estão envolvidos com a etiologia da mordida aberta anterior.

Occlusal and cephalometric characteristics of anterior open-bite among Colombian 5-10 years old school children / Características oclusales y esqueléticas de mordida abierta anterior en escolares colombianos de 5 a 10 años

Abstract: objetive. The aim of this study was to determine oclussal and skeletal characteristics of anterior open bite (AOB) according to sex and socioeconomic status (SES) in school children in the municipality of Pasto, Colombia. Methodology. A cross-sectional study was carried out involving 384 children between 5 and 10 years of age. A clinical assessment was performed to evaluate AOB, and information regarding socio-demographic variables, such as sex and SES according to Colombian standards, was obtained. Standardized lateral cephalograms and cast models were taken from participating subjects. A statistical analysis was performed using frequencies, percentages, t-student, ANOVA, Mann-Whitney and Kruskal-Wallis tests. Results. Prevalence of AOB was 8.1 percent, showing a significant difference according to SES. The most common Angle’s classification was Class II with 70.6 percent in the right molars, and 58.8 percent in the left molars, according to occlusal characteristics. Statistically significant differences were observed in the ratio of posterior and anterior facial height (PFH:AFH) (p=0.050) according to sex. The distance between the upper first molar and palatal plane (U6-PP) (p=0.028), the Overbite (p=0.032) and Gonial° (p=0.033) values showed statistically significant differences according to SES in vertical skeletal measures. The 64.7 percent of AOB were of dental origin. Conclusion. Results suggest variations in some vertical skeletal measures according to sex and SES in children with AOB. Since a high percentage of AOB is caused by dental factors, preventive programs are required to control this condition.

Resumen: el objetivo de este estudio fue determinar las características oclusales y esqueléticas de mordida abierta anterior (MAA) según sexo y nivel socioeconómico en escolares de Pasto, Colombia. Metodología. Se diseñó un estudio transversal con la participación de 384 niños entre 5 y 10 años. Se realizó una valoración clínica para evaluar la MAA y se obtuvo información sobre variables socio-demográficas como edad, sexo y estrato socioeconómico (ESE) basado en los parámetros de Colombia. A los participantes se les tomó cefalometrías laterales estandarizadas y modelos de estudio de yeso. Se hizo un análisis estadístico usando frecuencias, porcentajes, t-student, ANOVA, Mann- Whitney y Kruskal-Wallis. Resultados. La prevalencia de MAA fue 8,1 por ciento y existió una diferencia significativa según ESE. La clasificación de Angle más común fue la Clase II para el molar derecho en 70,6 por ciento e izquierdo: en 58,8 por ciento de acuerdo a las características oclusales. Diferencias estadísticamente significativas fueron observadas en la razón entre la altura facial posterior y anterior (PFH: AFH) según sexo (p=0,05). Los valores de la distancia entre el primer molar superior y el plano palatino (U6-PP) (p=0,028), el Overbite (p=0,032) y Gonial° (p=0,033) tuvieron una diferencia estadísticamente significativa con respecto al ESE en las medidas esqueléticas verticales. El 64,7 por ciento de MAA fueron de origen dental. Conclusión. Los resultados sugieren variaciones en algunas medidas esqueléticas verticales según sexo y ESE. Debido a que existe un alto porcentaje de MAA dental, se requieren programas preventivos para controlar esta condición.

Aporte del pediatra en la prevención de la mordida abierta anterior / Contribution of the pediatrician in the prevention of the anterior open bite

Históricamente es bien sabido que la mordida abierta anterior, conocida como la falta de contactos de los dientes anteriores superiores e inferiores es uno de los tipos de maloclusión que, aunque prevenible, afecta a gran parte de la población. La mayoría de los casos está asociada con la presencia de hábitos orales como la deglución atípica, la succión digital y la respiración bucal; así como, en menor proporción, con trastornos hereditarios y congénitos. El odontólogo especialista en ortodoncia es el profesional que tiene la tarea de aplicar el tratamiento correctivo adecuado una vez instalada la mordida abierta anterior ya que la misma afecta no sólo la cavidad bucal, sino también el aspecto facial del paciente, dependiendo de la severidad. Este podrá variar desde tratamientos ortopédicos, tratamientos ortodónticos, inclusive con extracción de premolares hasta cirugía ortognática. Afortunadamente este trastorno se puede prevenir y es el médico pediatra quien conjuntamente con el odontopediatra tiene el mayor peso en este sentido, a través del diagnóstico oportuno de los hábitos parafuncionales mediante una simple evaluación intra y extra oral del paciente. El trabajo preventivo del médico pediatra ayudaría a disminuir notoriamente la morbilidad de la mordida abierta anterior.

It is well known that the anterior open bite, previously known as lack of contact of upper and lower anterior teeth is one of the types of malocclusions that, although preventable, affects a large part of the population. Most cases are associated with the presence of oral habits such as atypical swallowing, thumb sucking and mouth breathing as well as hereditary and congenital disorders in a lesser extent. The dental specialist in orthodontics is the professional who has the task of applying the appropriate treatment after the anterior open bite is installed. According to its severity it not only affects the oral cavity but also the patient's facial appearance. Treatment may range from orthopedic treatments, including orthodontic treatment with premolar mutilation to orthognathic surgery. Fortunately this condition is preventable and it is the pediatrician together with the pediatric dentist who has the greatest importance in regard to the early diagnosis of parafunctional habits through a simple intra and extra oral assessment. The preventive approach of the pediatrician would help reduce the morbidity due to the anterior open bite.