Lauren S Todoki1, Samuel A Finkleman2, Ellen Funkhouser3, Geoffrey M Greenlee4, Kelly W Choi5, Hsiu-Ching Ko4, Hsuan-Fang Wang6, Peter A Shapiro4, Roozbeh Khosravi4, Camille Baltuck7, Veerasathpurush Allareddy8, Calogero Dolce9, Chung How Kau10, Kyungsup Shin11, Jaime de Jesus-Vinas12, Michael Vermette13, Cameron Jolley14, Greg J Huang4. 1. Private Practice, Seattle, Wash. Electronic address: ltodoki@gmail.com. 2. Private Practice, Seattle, Wash. 3. Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. 4. Department of Orthodontics, University of Washington, Seattle, Wash. 5. Private Practice, Santa Rosa, Calif. 6. Department of Orthodontics, University of Washington, Seattle, Wash; Division of Orthodontics, Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan. 7. Western Region, National Dental Practice-Based Research Network, Portland, Ore. 8. Department of Orthodontics, and Specialty Node, National Dental Practice-Based Research Network, University of Illinois at Chicago, Chicago, Ill. 9. Department of Orthodontics, University of Florida, Gainesville, Fla. 10. Department of Orthodontics, University of Alabama at Birmingham, Birmingham, Ala. 11. Department of Orthodontics, University of Iowa, Iowa City, Iowa. 12. Private Practice, San Juan, Puerto Rico. 13. Private Practice, Concord, NH. 14. Private Practice, Trophy Club, TX.
Abstract
INTRODUCTION: Anterior open bite (AOB) continues to be a challenging malocclusion for orthodontists to treat and retain long-term. There is no consensus on which treatment modality is most successful. This study reports on the overall success rate of AOB orthodontic treatment in the adult population across the United States, as well as 4 major treatment modalities and other factors that may influence treatment success. METHODS: Practitioners and their adult patients with AOB were recruited through the National Dental Practice-Based Research Network. Patient dentofacial and demographic characteristics, practitioner demographic and practice characteristics, and factors relating to orthodontic treatment were reported. Treatment success was determined from posttreatment (T2) lateral cephalometric films and intraoral frontal photographs. Treatment was categorized into 4 main groups: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also evaluated. Bivariate and multivariable models were used to investigate the association between treatment success and treatment modality, pretreatment (T1) dentofacial characteristics, patient and practitioner demographics, and practice characteristics, adjusting for clustering of patients within practice. RESULTS: A total of 254 patients, enrolled by 84 practitioners, contributed to T2 data for this study. There were 29 patients in the aligner group, 152 in fixed appliances, 20 in TADs, and 53 in surgery. A total of 49 patients underwent extractions of teeth other than third molars. Ninety-three percent finished treatment with a positive overbite on the T2 lateral cephalogram, and 84% finished with a positive vertical overlap of all incisors. The small number of aligners and TAD patients limited the ability to compare success rates in these groups. Patients treated with orthognathic surgery had a higher rate of success compared with those treated with fixed appliances only. Treatment success was also associated with academic practice setting, T1 mandibular plane angle ≤30°, no to mild T1 crowding, and treatment duration <30 months. CONCLUSIONS: The overall success of orthodontic treatment in adult patients with AOB who participated in this study was very high. Orthognathic surgery was the only treatment modality that exhibited a statistically higher odds of successful outcomes. Some T1 dentofacial characteristics and treatment factors were associated with the successful closure of AOB.
INTRODUCTION:Anterior open bite (AOB) continues to be a challenging malocclusion for orthodontists to treat and retain long-term. There is no consensus on which treatment modality is most successful. This study reports on the overall success rate of AOB orthodontic treatment in the adult population across the United States, as well as 4 major treatment modalities and other factors that may influence treatment success. METHODS: Practitioners and their adult patients with AOB were recruited through the National Dental Practice-Based Research Network. Patient dentofacial and demographic characteristics, practitioner demographic and practice characteristics, and factors relating to orthodontic treatment were reported. Treatment success was determined from posttreatment (T2) lateral cephalometric films and intraoral frontal photographs. Treatment was categorized into 4 main groups: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also evaluated. Bivariate and multivariable models were used to investigate the association between treatment success and treatment modality, pretreatment (T1) dentofacial characteristics, patient and practitioner demographics, and practice characteristics, adjusting for clustering of patients within practice. RESULTS: A total of 254 patients, enrolled by 84 practitioners, contributed to T2 data for this study. There were 29 patients in the aligner group, 152 in fixed appliances, 20 in TADs, and 53 in surgery. A total of 49 patients underwent extractions of teeth other than third molars. Ninety-three percent finished treatment with a positive overbite on the T2 lateral cephalogram, and 84% finished with a positive vertical overlap of all incisors. The small number of aligners and TAD patients limited the ability to compare success rates in these groups. Patients treated with orthognathic surgery had a higher rate of success compared with those treated with fixed appliances only. Treatment success was also associated with academic practice setting, T1 mandibular plane angle ≤30°, no to mild T1 crowding, and treatment duration <30 months. CONCLUSIONS: The overall success of orthodontic treatment in adult patients with AOB who participated in this study was very high. Orthognathic surgery was the only treatment modality that exhibited a statistically higher odds of successful outcomes. Some T1 dentofacial characteristics and treatment factors were associated with the successful closure of AOB.
Authors: Adelina M Fontes; Donald R Joondeph; Dale S Bloomquist; Geoffrey M Greenlee; Terry R Wallen; Greg J Huang Journal: Am J Orthod Dentofacial Orthop Date: 2012-12 Impact factor: 2.650