Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction

Han-ah Lee; Young-chel Park

doi:10.4041/kjod.2008.38.1.31

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Lee and Park: Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction

Original Article

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2008; 38(1): 31-40.

Published online: 29 February 2008

DOI: https://doi.org/10.4041/kjod.2008.38.1.31

Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction

Han-ah Lee, DDS, MSD^a, Young-chel Park, DDS, MSD, PhD^b

^aResident, Department of Orthodontics, college of Dentistry, Yonsei University, Seoul, Korea.

^bProfessor, Department of Orthodontics, college of Dentistry, Yonsei University, Seoul, Korea.

Corresponding author: Young-chel Park. Department of Orthodontics, College of Dentistry, Yonsei University, Shinchon-dong 134, Seodaemun-Gu, Seoul, 120-752, Korea. +82 02 2228 3000, ypark@yuhs.ac.

Received 29 August 2007 Revised 29 November 2007 Accepted 1 December 2007

Abstract

Objective

This study investigated the skeletal and dentoalveolar changes after intrusion of maxillary posterior teeth using miniscrew implants during the treatment and posttreatment period.

Method

The subjects consisted of 11 adults (1 male, 10 females) whose open bites were treated by posterior teeth intrusion with miniscrew. The lateral cephalometric x-rays of pre-treatment, post-treatment, and the retention period were evaluated.

Results

The average intrusion of maxillary posterior teeth at the end of the treatment period was 2.22 mm (p < 0.001) and the average extrusion of maxillary posterior teeth at the end of the 17.4 month retention period was 0.23 mm (p = 0.359). The relapse rate was calculated at 10.36%. A decrease in overbite after the 17.4 month retention period was 0.99 mm (p < 0.05). The relapse rate was calculated at 18.10%. The skeletal changes and vertical height change of maxillary posterior teeth during the retention period was statistically insignificant, but there was a significant decrease in overbite (mean 0.99 mm, p < 0.05). The amount of intrusion and the overbite improvement from treatment significantly correlates to the degree of relapse.

Conclusions

The results indicate that intrusion of the maxillary posterior teeth using miniscrews is an effective, non-surgical treatment modality which can reasonably be used to address adult open bite.

Keywords: Intrusion of maxillary posterior teeth, Open-bite, Miniscrew implant, Stability

Figures and Tables

Fig 1

Appliance for intrusion of maxillary molars using miniscrew. A, Miniscrew insertion on buccal and palatal sides (buccal view); B, miniscrew insertion on buccal and palatal sides (palatal view); C, miniscrew insertion on the buccal side only, with a palatal rigid splint for preventing buccal tipping (transverse view); D, miniscrew insertion on the buccal side only, with a palatal rigid splint for preventing buccal tipping (palatal view).

Fig 2

Cephalometric landmarks and reference planes. S (Sella), N (nasion), Ar (articulare), P (porion), Go (gonion), Me (menton), Gn (gnathion), Po (pogonion), Or (orbitale), ANS (anterior nasal spine), PNS (posterior nasal spine), A (A point), B (B point), U1 (upper incisor tip), U6 (upper molar mesiobuccal cusp tip), L1 (lower incisor tip), L6 (lower molar mesiobuccal cusp tip), Pog' (soft tissue pogonion); SN (SN plane), a line through sella and nasion; FH (FH plane), a line through orbitale and porion; HP (horizontal reference plane), a line through nasion rotated 7° from sella-nasion line; VP (vertical reference plane), a line through sella and perpendicular line to HP; PP (palatal plane), a line through ANS and PNS; MP (mandibular plane), a line through menton and gonion.

Fig 3

Skeletal angular measurements. a, SN-GoMe; b, S-N-Pog; c, SNA, S-N-A angle; d, SNB, S-N-B angle; e, ANB difference, c-d; f, IMPA, mandibular incisor long axis to Mn. plane; g, FMA, FH-MP.

Fig 4

Skeletal and dental linear measurements. 1, N-Me, Anterior facial height; 2, VP-Pog, Antero-posterior location of pogonion; 3, U6-PP (mm), perpendicular distance between mesiobuccal cusp of Mx. first molar to palatal plane; 4, U1-PP (mm), perpendicular distance between Mx. incisor edge to palatal plane; 5, OB (mm), distance between incisal edges of maxillary and mandibular central incisors, perpendicular to horizontal reference plane; 6, OJ (mm), distance between incisal edges of maxillary and mandibular central incisors, perpendicular to vertical reference plane.

Table 1

Cephalometric measurements before treatment (T1), after treatment (T2), and during retention period (T3)

SD, Standard deviation

Table 2

Mean treatment changes (T2-T1) and posttreatment changes (T3-T2)

Negative value means decrease during treatment, positive value means increase during treatment. T1, Before treatment; T2, after treatment; T3, retention period; SD, standard deviation; Sig, significance; NS, not significant; ^*p < 0.05, ^†p < 0.01, ^‡p < 0.001.

Table 3

Correlations between changes of variables (T2-T1)

T1, Before treatment; T2, after treatment; R, Pearson's correlation coefficiency; Sig, significance; ^*p < 0.05, ^†p < 0.01, ^‡p < 0.001.

Table 4

Correlation between pre-treatment variables and change of OB (T3-T2)

T1, Before treatment; T2, after treatment; T3, retention period; R, Pearson's correlation coefficiency; Sig, significance; NS, not significant.

Table 5

Correlation between T2-T1 variables and T3-T2 variables

T1, Before treatment; T2, after treatment; T3, retention period; R, Pearson's correlation coefficiency; Sig, significance; ^*p < 0.05.

Table 6

Relapse rate of OB, U6-PP, AFH

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