Journal List > Korean J Orthod > v.38(1) > 1043560

Korean J Orthod. 2008 Feb;38(1):31-40. Korean.
Published online February 29, 2008.  https://doi.org/10.4041/kjod.2008.38.1.31
Copyright © 2008 Korean Association of Orthodontists
Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction
Han-ah Lee, DDS, MSD,a and Young-chel Park, DDS, MSD, PhDb
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, Email: ypark@yuhs.ac.
Received August 29, 2007; Revised November 29, 2007; Accepted December 01, 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


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).
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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.
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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.
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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.
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Tables


Table 1
Cephalometric measurements before treatment (T1), after treatment (T2), and during retention period (T3)
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Table 2
Mean treatment changes (T2-T1) and posttreatment changes (T3-T2)
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Table 3
Correlations between changes of variables (T2-T1)
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Table 4
Correlation between pre-treatment variables and change of OB (T3-T2)
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Table 5
Correlation between T2-T1 variables and T3-T2 variables
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Table 6
Relapse rate of OB, U6-PP, AFH
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References
1. Lopez-Gavito G, Wallen TR, Little RM, Joondeph DR. Anterior open bite malocclusion: A longitudinal 10-year postretention evaluation of orthodontically treated patients. Am J Orthod 1985;87:175–186.
2. Janson G, Valarelli FP, Beltrao RT, De Freitas MR, Henriques JFC. Stability of anterior open bite extraction and nonextraction treatment in the permanent dentition. Am J Orthod Dentofacial Orthop 2006;129:768–774.
3. Janson G, Valarelli FP, Henriques JFC, De Freitas MR, Cancado RH. Stability of anterior open bite nonextraction treatment in the permanent dentition. Am J Orthod Dentofacial Orthop 2003;124:265–276.
4. Kuster R, Ingervall B. The effect of treatment of skeletal open bite with two types of bite blocks. Eur J Orthod 1992;14:489–499.
5. Rinchuse DJ. Vertical elastics for correction of anterior open bite. J Clin Orthod 1994;28:284.
6. Chang YI, Moon SC. Cephalometric evaluation of the anterior open bite treatment. Am J Orthod Dentofacial Orthop 1999;115:29–38.
7. Denison TF, Kokich VG, Shapiro PA. Stability of maxillary surgery in openbite versus nonopenbite malocclusions. Angle Orthod 1989;59:5–10.
8. Proffit WR, Bailey LJ, Phillips C, Turvey TA. Long-term stability of surgical open bite correction by Le Fort I osteotomy. Angle Orthod 2000;70:112–117.
9. Ko DI, Lim SH, Kim KW. Treatment of occlusal plane canting using miniscrew anchorage. World J Orthod 2006;7:269–278.
10. Park HS, Kwon OW, Sung JH. Nonextraction treatment of an open bite with microscrew implant anchorage. Am J Orthod Dentofacial Orthop 2006;130:391–402.
11. Park YC, Lee SY, Kim DH, Jee SH. Intrusion of posterior teeth using mini-screw implants. Am J Orthod Dentofacial Orthop 2003;123:690–694.
12. Sherwood KH, Burch JG, Thompson WJ. Closing anterior open bites by intruding molars with titanium miniplate anchorage. Am J Orthod Dentofacial Orthop 2002;122:593–600.
13. Umemori M, Sugawara J, Mitani H, Nagasaka H, Kawamura H. Skeletal anchorage system for open bite correction. Am J Orthod Dentofacial Orthop 1999;115:166–174.
14. Xun C, Zeng X, Wang X. Microscrew anchorage in skeletal anterior open bite treatment. Angle Orthod 2007;77:47–56.
15. Sugawara J, Baik UB, Umemori M, Takahashi I, Nagasaka H, Kawamura H, et al. Treatment and posttreatment dentoalveolar changes following intrusion of mandibular molars with application of a skeletal anchorage system (SAS) for open bite correction. Int J Adult Orthodon Orthognath Surg 2002;17:243–253.
16. Sassouni V. A classification of skeletal facial types. Am J Orthod 1969;55:109–123.
17. Schudy FF. The rotation of the mandible resulting from growth: its implication in orthodontic treatment. Angle Orthod 1965;35:36–50.
18. Reitan K, Rygh P. Biomechanical principles and reactions. In: Graber TM, Vanarsdall RL, editors. Orthodontics-current principles and techniques. 2nd ed. St. Louis: Mosby; 1994. pp. 168-169.
19. Beckmann SH, Segner D. Floating norms and post-treatment overbite in open bite patients. Eur J Orthod 2002;24:379–390.
20. Proffit WR, Mason RM. Myofunctional therapy for tongue thrusting background and recommendations. J Am Dent Assoc 1975;90:403–411.