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KJO Korean Journal of Orthodontics

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eISSN 2005-372X
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Korean J Orthod

Published online November 24, 2021

Copyright © The Korean Association of Orthodontists.

Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients

Heeyeon Suha; Bella Shen Garnettb; Kimberly Mahoodc; Noor Mahjoubd; Robert L Boyde; Heesoo Ohf

a Research Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
b Private Practice, San Francisco and Adjunct Clinical Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
c Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
d Private Practice, San Francisco, CA
e Professor Emeritus, Former Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
f Professor and Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA

Correspondence to:Dr. Heesoo Oh, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 Fifth Street, San Francisco, CA, 94103, USA
E-mail: hoh@pacific.edu

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy in correcting adult anterior open bites.
Methods: In this retrospective study, the sample was drawn from a single clinician’s practice. Sixty-nine adult anterior open bite patients (OB < -0.5 mm) were collected and classified into Class I, II, and III groups. Fifty patients presented with skeletal open bites (MPA ≥ 38°), and 19 patients presented with dental open bites. Fifteen cephalometric landmarks at pre (T1)- and post treatment (T2) were identified. The magnitude of planned and actual movements of the incisors and molars were calculated.
Results: Positive overbite with mean final overbite of 1.1 ± 0.8 mm was achieved in 94% of adult patients. The mean overbite change was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of upper molar intrusion was achieved. The Class II group showed greater intrusion of the upper molars and greater reduction of the mandibular plane angle than the Class I group. The Class III group showed greater lower incisor extrusion and no significant vertical skeletal changes.
Conclusions: Clear aligners can be effective in controlling vertical dimension and correcting mild to moderate anterior open bites in adult patients. Treatment mechanism for Class III group was significantly different from Class I and Class II groups. Upper incisor extrusion in the dental open bite and MPA reduction and lower incisor extrusion in the skeletal open bite were the most significant contributing factors for open bite closure.

Keywords: Clear aligner, Orthodontic treatment, Tooth movement, Anterior open bite

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Korean J Orthod

Published online November 24, 2021

Copyright © The Korean Association of Orthodontists.

Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients

Heeyeon Suha; Bella Shen Garnettb; Kimberly Mahoodc; Noor Mahjoubd; Robert L Boyde; Heesoo Ohf

a Research Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
b Private Practice, San Francisco and Adjunct Clinical Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
c Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
d Private Practice, San Francisco, CA
e Professor Emeritus, Former Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA
f Professor and Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA

Correspondence to:Dr. Heesoo Oh, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 Fifth Street, San Francisco, CA, 94103, USA
E-mail: hoh@pacific.edu

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy in correcting adult anterior open bites.
Methods: In this retrospective study, the sample was drawn from a single clinician’s practice. Sixty-nine adult anterior open bite patients (OB < -0.5 mm) were collected and classified into Class I, II, and III groups. Fifty patients presented with skeletal open bites (MPA ≥ 38°), and 19 patients presented with dental open bites. Fifteen cephalometric landmarks at pre (T1)- and post treatment (T2) were identified. The magnitude of planned and actual movements of the incisors and molars were calculated.
Results: Positive overbite with mean final overbite of 1.1 ± 0.8 mm was achieved in 94% of adult patients. The mean overbite change was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of upper molar intrusion was achieved. The Class II group showed greater intrusion of the upper molars and greater reduction of the mandibular plane angle than the Class I group. The Class III group showed greater lower incisor extrusion and no significant vertical skeletal changes.
Conclusions: Clear aligners can be effective in controlling vertical dimension and correcting mild to moderate anterior open bites in adult patients. Treatment mechanism for Class III group was significantly different from Class I and Class II groups. Upper incisor extrusion in the dental open bite and MPA reduction and lower incisor extrusion in the skeletal open bite were the most significant contributing factors for open bite closure.

Keywords: Clear aligner, Orthodontic treatment, Tooth movement, Anterior open bite