Skeletal and dento-alveolar stability after surgical-orthodontic treatment of anterior open bite: a retrospective study.
The aim of this investigation was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction of skeletal anterior open bite treated by maxillary intrusion (group A) versus extrusion (group B). The cephalometric records of 49 adult anterior open bite patients (group A: n = 38, group B: n = 11), treated by the same maxillofacial surgeon, were examined at different timepoints, i.e. at the start of the orthodontic treatment (T1), before surgery (T2), immediately after surgery (T3), early post-operatively (+/- 20 weeks, T4) and one year post-operatively (T5). A bimaxillary operation was performed in 31 of the patients in group A and in six in group B. Rigid internal fixation was standard. If maxillary expansion was necessary, surgically assisted rapid palatal expansion (SRPE) was performed at least 9 months before the Le Fort I osteotomy. Forty-five patients received combined surgical and orthodontic treatment. The surgical open bite reduction (A, mean 3.9 mm; B, mean 7.7 mm) and the increase of overbite (A, mean 2.4 mm; B, mean 2.7 mm), remained stable one year post-operatively. SNA (T2-T3), showed a high tendency for relapse. The clockwise rotation of the palatal plane (1.7 degrees; T2-T3), relapsed completely within the first post-operative year. Anterior facial height reduction (A, mean -5.5 mm; B, mean -0.8 mm) occurred at the time of surgery. It can be concluded that open bite patients, treated by posterior Le Fort I impaction as well as with anterior extrusion, with or without an additional bilateral sagittal split osteotomy (BSSO), one year post-surgery, exhibit relatively good clinical dental and skeletal stability.
Swinnen
K
K
Department of Orthodontics, Katholieke Universiteit Leuven, Belgium.
Politis
C
C
Willems
G
G
De Bruyne
I
I
Fieuws
S
S
Heidbuchel
K
K
van Erum
R
R
Verdonck
A
A
Carels
C
C
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000473:pathology*; D001860:Bone Plates; D002508:Cephalometry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery; D008437:Maxilla / Q000473:pathology* / Q000601:surgery; D024343:Open Bite / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D009971:Orthodontics, Corrective; D010027:Osteotomy / Q000379:methods; D019340:Osteotomy, Le Fort; D010155:Palatal Expansion Technique; D012008:Recurrence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012399:Rotation; D013223:Statistics as Topic; D014070:Tooth / Q000473:pathology*; D016896:Treatment Outcome; D014716:Vertical Dimension