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Noninvasive conservative management of anterior open bite treated with TADs versus clear aligner therapy

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Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

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.

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Data Availability

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the following orthodontist: Dr Louis Dorval, Dre Isabelle Baillargeon, Dr Roger Drouin for providing patients for the CAT group. In addition, the authors also thank Mrs. Anne-Sophie Julien, MSc, for the statistical consultation and analysis and Dr Bill Wilson, University of Toronto, for reviewing the manuscript.

Funding

The research did not receive any funding.

However, the main author (SC) paid from his personal money, the honorarium of the statistician.

Author information

Authors and Affiliations

  1. Private Practice, 10345 Boul. de L’Ormière, Quebec, Qc, G2B 3L2, Canada

    Sylvain Chamberland

  2. Private Practice, Paris, France

    Noé Nataf

Authors
  1. Sylvain Chamberland
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  2. Noé Nataf
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Contributions

SC contributed to conceptualization, original draft preparation, methodology, validation, resources original draft preparation, manuscripts review and editing, visualization, supervision, and project administration; NN contributed to methodology, validation, data curation manuscript reviews and editing, and visualization

All authors have read and approved the manuscript.

Corresponding author

Correspondence to Sylvain Chamberland.

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Competing interests

The authors declare no competing interests.

Ethical and consent to participate

As the study was retrospective, the research was not reviewed by an ethic committee.

All the patients completed a written informed consent to use their data for publication.

The consent was written. See the following paragraph.

Consent for publication

The patients agreed that the data relating to diagnosis, treatment may be used for educational purposes of teaching, examinations, research, conferences, and scientific publication.

Competing interest

Each of the authors certifies that he has no affiliation with or involvement in any organization or entity with a financial interest.

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Chamberland, S., Nataf, N. Noninvasive conservative management of anterior open bite treated with TADs versus clear aligner therapy. Clin Oral Invest 28, 236 (2024). https://doi.org/10.1007/s00784-024-05634-1

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