Early treatment of skeletal open-bite malocclusion

ABSTRACT DATA SOURCES Studies were identified by searching the Cochrane Controlled Clinical Trials Register and Medline. STUDY SELECTION Randomised clinical trials (RCT), prospective and

retrospective studies that had concurrent untreated as well as normal controls, and clinical trials that compared at least two treatment strategies but did not have any untreated or normal

control group were included. The following were excluded: case series; descriptive studies; case reports; studies concerning treatment in the permanent dentition/ adult patients, surgically

assisted treatment, treatment combined with extractions, treatment with full-fixed appliances; and discussion or debate articles. DATA EXTRACTION AND SYNTHESIS Year of publication, study

design, materials, dropouts, measurements, treatment time, success rate, decrease of open bite and divergence, side effects, costs, and authors' conclusions were recorded. Two

independent reviewers assessed the articles independently and a quality evaluation and qualitative summary were performed. RESULTS A total of 1049 articles were identified of which seven

were included in the review. No RCT of early treatment of anterior open bite have been performed. Two controlled clinical trials of early anterior open bite were identified, and these both

indicated the effectiveness of treatment in the mixed dentition with headgear or functional appliances (or both). Most of the studies had serious problems with lack of power because of small

sample size, bias and confounding variables; lack of method-error analysis or blinding in measurements; and deficient or lack of statistical methods. CONCLUSIONS The quality of the studies

was insufficient to allow any evidence-based conclusions to be drawn. RCT of sufficient sample size are still needed to determine which treatment is the most effective for early correction

of skeletal open bite. Future studies should also include the assessment of long-term stability as well as an analysis of the cost and side-effects of the interventions. SIMILAR CONTENT

BEING VIEWED BY OTHERS TREATMENT DECISIONS OF PATIENTS WITH CLASS II DIVISION 2 MALOCCLUSION AND SEVERE TOOTH WEAR: A SYSTEMATIC REVIEW Article Open access 13 August 2024 THE EFFECTIVENESS

OF ANTERIOR UNILATERAL BITE TURBOS IN CORRECTING INCISAL PLANE CANT AND ASYMMETRIC OVERBITE: A PROSPECTIVE CLINICAL STUDY Article Open access 06 May 2025 LIMITED EVIDENCE ON DIFFERENCES

BETWEEN FIXED APPLIANCES AND CLEAR ALIGNERS REGARDING PAIN LEVEL Article 18 December 2020 COMMENTARY This article addresses an important issue in early orthodontic treatment. The aim of this

review was to find out if early treatment of open-bite is effective, which treatment modality is most effective, and if the result is stable. Unfortunately, the authors were not able to

answer these questions because of a series of drawbacks in the studies reviewed. The review was well-designed and properly performed, although there are two points that require

clarification. The title is, “Early orthodontic treatment of skeletal open-bite malocclusion” and yet there was no discrimination between dental or skeletal open-bite in neither the search

strategy nor the description of the results. Both terms were used in the review without clear definitions. _(The review authors have since indicated that a majority of papers described

treatment of malocclusions that presented with a combination of both dental and skeletal open-bite.)_ Secondly, “success rate” was given as one of the parameters for evaluating the results,

but it was not clear how the authors defined the success rate, nor how the reviewed studies defined it. Is the presence of front contact a success? Or should it be the presence of vertical

overlap of the front teeth? In their inclusion criteria, the authors did not set any restrictions for sample size while noting in the Results that this was a major drawback. It seems that if

sample size was included as one of the initial inclusion criteria, the conclusion could have been drawn without going into the details. Looking at the year of publication of the seven

included studies, five are from 1992, one is from 1990 and one from 1983. It seems that the orthodontic field has not added new evidence to the literature for the past 14 years. Also related

to the year of publication, it is understandable that ethical approval — a requirement for recent publications — was missing in all the reviewed studies. A quick check in PubMed for

systematic reviews or meta-analysis in orthodontics indicates that many of the results point to similar conclusions: “the results are inconclusive”; “there is no evidence or only a lower

level of evidence”, and, “randomised clinical trials, cost analysis and long-term studies are needed”. Regarding all the reviews, one wonders if studies of this nature or such inconclusive

reviews should be considered before the significance of their contribution to the orthodontic literature is evaluated.1 PRACTICE POINT The quality of studies in this area is insufficient to

draw any evidence-based conclusions. REFERENCES * Papadopoulos MA . Meta-analysis in evidence-based orthodontics. _Orthod Craniofac Res_ 2003; 6:112–126.. Article  Google Scholar  Download

references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Orthodontics, University Medical Centre Groningen, Groningen, The Netherlands Yijin Ren Authors * Yijin Ren View author

publications You can also search for this author inPubMed Google Scholar ADDITIONAL INFORMATION Address for correspondence: Lorenzo Franchi, Dipartimento di Odontostomatologia, Università

degli Studi di Firenze, Via del Ponte di Mezzo, 46-48, Firenze 50127, Italy. E-mail: [email protected]. COZZA P, MUCEDERO M, BACCETTI T, FRANCHI L. _Early orthodontic treatment of

skeletal open-bite malocclusion: a systematic review. Angle Orthod 2005; 75: 707–713_ RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Ren, Y. Early

treatment of skeletal open-bite malocclusion. _Evid Based Dent_ 7, 103 (2006). https://doi.org/10.1038/sj.ebd.6400450 Download citation * Published: 24 December 2006 * Issue Date: December

2006 * DOI: https://doi.org/10.1038/sj.ebd.6400450 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link

is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative