Vertical proportions: A guide for prognosis and treatment in anterior open-bite

doi:10.1016/0002-9416(77)90055-0

American Journal of Orthodontics

Volume 72, Issue 2, August 1977, Pages 128-146

https://doi.org/10.1016/0002-9416(77)90055-0 Get rights and content

Abstract

1.
1. Most open-bites are deficient in growth of the upper face and in growth of the posterior face. However, some varieties have adequate posterior face height. A compensatory increase in lower anterior face height occurs in both types.
2.
2. The ratio of upper anterior face height to lower anterior face height ( $UAFH LAFH$ ) is suggested as an aid in determining the prognosis for the orthodontic correction of anterior open-bite.
3.
3. The treatments of eight patients were presented to illustrate this concept. The results were critically analyzed.
4.
4. The validity of this index can be determined only after prolonged use by many orthodontists.

References (5)

H.I. Nahoum et al.
Varieties of anterior open-bite
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H.I. Nahoum
Vertical proportions and the palatal plane in anterior open-bite
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(1971)

There are more references available in the full text version of this article.

Cited by (51)

Comparison of mesiodistal angulations of premolars and molars in anterior open bite subjects with different sagittal malocclusions: A retrospective study
2024, International Orthodontics
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.
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).
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.
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.
Non-orthodontic intervention and non-nutritive sucking behaviours: A literature review
2018, Kaohsiung Journal of Medical Sciences
Citation Excerpt :
There are two categories of the open bite, skeletal and dental. The craniofacial features constantly linked with the skeletal open bite are increased mandibular plane angle and gonial angle, with a long anterior facial height and an overall increased facial height as well as a retrognathic mandible with palatal plane anteriorly tipped upwards [5–11]. On the other hand, the dental open bite is generally accompanied by normal craniofacial configurations, with incisors that are proclined and under-erupted anterior teeth as well as a normal molar height with thumb-sucking or other oral habits [2].
Anterior open bite (AOB) is one of the most complex malocclusions to manage. AOB is caused by either by skeletal, genetic or environmental factors. Numerous treatment options are currently utilised to manage AOB. These vary from non-invasive behavioural shaping to orthodontic and surgical interventions. This paper reviews the available orthodontic and non-orthodontic interventions used in the management of AOB. The literature review was carried out using the PubMed search engine from the first of January 2000 to the first of June 2017. Two major keywords (open bite and anterior open bite) were used in addition to 23 minor keywords in the review. AOB is one of the most complex malocclusions to treat with high relapse rates. Long term outcome in treatments of patients with AOB was substantially low. Relapse rates were not taken into consideration for some of the literature reviewed. Despite limitations of the literature, it is recommended that orofacial myofunctional therapy (OMT) and non-orthodontic intervention (NOI) be used in conjunction as an effective treatment option for Anterior Open Bite.
Evaluation of long-term stability of skeletal anterior open bite correction in adults treated with maxillary posterior segment intrusion using zygomatic miniplates
2016, American Journal of Orthodontics and Dentofacial Orthopedics
Citation Excerpt :
Similar correlations were found by Lee and Park,22 whereas Baek et al23 reported a significant correlation for the change in overbite only. Therefore, our results support the premises that the initial open-bite severity and the amount of open-bite correction play important roles in open-bite relapse.40-44 Hence, it is advisable to overcorrect the overbite to counteract the inevitable relapse and to match the overcorrection to the initial severity of the malocclusion.
This study evaluated the long-term stability of maxillary molar intrusion and anterior open-bite correction in adults treated by maxillary posterior teeth intrusion with zygomatic miniplates.
The sample included 26 skeletal anterior open-bite patients, who had maxillary posterior segment intrusion with zygomatic miniplates. Lateral cephalograms were taken at pretreatment, posttreatment, 1 year posttreatment, and 4 years posttreatment.
The mean maxillary molar intrusion was 3.04 mm (P ≤0.01), and the mean bite closure was 6.93 mm (P ≤0.01). The intruded maxillary molars relapsed by 10.20% in the first year after treatment and by 13.37% by 4 years after treatment. Overbite relapsed by 8.19% and 11.18% after 1 year and 4 years posttreatment, respectively. The first year after treatment accounted for 76.29% and 73.2% of the total relapses of molar intrusion and overbite, respectively. The 4-year posttreatment relapse amounts of maxillary molar intrusion and overbite were positively correlated with the amount of pretreatment maxillary molar height and the initial open-bite severity, respectively, but negatively correlated with the amounts of maxillary molar intrusion and open-bite correction gained by treatment.
Molar intrusion with zygomatic miniplates appears to be stable 4 years after treatment.
How to achieve proper overbite - Lessons from natural dentoalveolar compensation
2013, Journal of Dental Sciences
Citation Excerpt :
However, one of the most frequently used characteristic measurements to represent facial divergence clinically, the SN-MP angle, was excluded from the stepwise (logistic) regressions in both groups. This corresponded to the findings in other literatures that SN-MP alone could not delineate the vertical characteristics in facial types; instead, the following measurements were emphasized: the steepness of the mandible,4,5 the gonial angle,5 OP-MP,6 PFH/AFH,7 and UAFH/LAFH.8 The measurement of gonial angle was further divided into upper and lower gonial angles in this study.
To identify how dentoalveolar changes compensate for proper overbite in extreme vertical facial patterns.
Lateral cephalometric roentgenograms of preorthodontic adult patients with hyperdivergent (n = 49; SN-mandibular plane (MP) angle greater than 38 degrees) and hypodivergent (n = 38; SN-MP angle less than 28 degrees) skeletal patterns were selected. Skeletal-vertical (SV) variables were selected and summarized via stepwise regression methods and principal component analysis (PCA) in these two groups. Multiple regression analyses were performed to determine the relationship between overbite (OB) as the dependent variable and the PCA-derived SV, dental height (DH), and dental inclination (DI) as the independent variables.
Hyperdivergent patients have the tendency of anterior open bite. The natural dentoalveolar compensatory mechanism is manifested in shorter upper molar height and larger lower incisor height. Hypodivergent patients have no tendency of anterior deep bite. The shorter upper and lower incisor DHs and larger incisal inclination achieved dentoalveolar compensatory mechanism in these patients.
For orthodontically closing the open bite, intruding upper posteriors and extruding lower anteriors are appropriate ways to simulate the natural occurring compensation. To eliminate deep bite in a low mandibular plane patient, intruding upper and lower anteriors and proclining anteriors will achieve good overbite. Imitating the natural dentoalveolar compensation by using temporary anchorage devices at appropriate sites for intruding teeth helps to resolve orthodontic vertical problems.
Dentoalveolar compensation in Iranian adult skeletal open bite subjects
2013, Orthodontic Waves
Citation Excerpt :
In anterior dentoalveolar region, increased heights of upper and lower jaws were observed in OBG (open bite groups including both COBG and NCOBG) compared to CG. This result is consistent with findings of some studies [13,26,27] but differ from those of others [8,16,17]. These features are signs of compensatory dentoalveolar mechanisms in skeletal open bite patients to minimize the severity of skeletal problems.
The aim of present study was to compare skeletal and dentoalveolar features of compensated and noncompensated adult open bite subjects with each other and also with those of control group.
A total of 100 lateral cephalograms were included in the study and were divided according to skeletal vertical characteristics into two groups: control group (CG) and open bite group (OBG). The OBG further divided into two subgroups based on amount of overbite: dentally compensated open bite group (COBG) and non compensated open bite group (NCOBG). Twenty skeletal and dentoalveolar variables were evaluated and compared between OBG and CG and also between open bite subgroups by means of Student t-test. Association between different variables and overbite was assessed using Pearson's correlation coefficient.
Increased molar and incisor height in both jaws were observed in OBG compared to CG. In NCOBG lower anterior facial height and lower posterior dentoalveolar height were significantly higher than COBG.
Dentoalveolar compensatory mechanisms in skeletal open bite patients consist of increased anterior and posterior dentoalveolar heights in upper and lower jaws compared to CG, while decreased mandibular molar height and shorter anterior face height are the most important determinants of adequate compensation in skeletal open bite subjects in our sample.
The segmented arch approach: A method for orthodontic treatment of a severe Class III open-bite malocclusion
2013, American Journal of Orthodontics and Dentofacial Orthopedics
An open bite is a common malocclusion, and it is generally associated with several linked etiologic factors. When establishing the treatment plan, it is essential to consider every aspect of the various etiologic causes and their evolution; this will help to correct it. This article reports the case of a girl aged 10.7 years with a skeletal Class III malocclusion and an open bite. The treatment mechanics were based on compensatory dental changes performed to close the bite and correct the skeletal Class III malocclusion. The patient had a deep maxillary deficiency, and the lower facial third was severely enlarged. In this article, we aimed to describe a simple mechanical approach that will close the bite through changes in the occlusal plane (segmentation of arches). It is an extremely simple method that is easily tolerated by the patient. It not only closes the bite effectively but also helps to correct the unilateral or bilateral lack of occlusal interdigitation between the dental arches. A Class III patient with an anterior open bite is shown in this article to illustrate the effectiveness of these treatment mechanics.

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^☆: Presented before the Northeastern Society of Orthodontists, Oct. 20, 1976.

^∗: Professor of Dentistry, Columbia University School of Dental and Oral Surgery.

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Original articleVertical proportions: A guide for prognosis and treatment in anterior open-bite☆

Abstract

Am. J. Orthod.

Am. J. Orthod.

Original article
Vertical proportions: A guide for prognosis and treatment in anterior open-bite☆