Dentoskeletal changes in open bite treatment using spurs and posterior build-ups: A randomized clinical trial

Author(s)

Aliaga-Del Castillo, Aron ^[1] ; Vilanova, Lorena ^[1] ; Miranda, Felicia ^[1] ; Arriola-Guillen, Luis Ernesto ^{[2, 3]} ; Garib, Daniela ^{[4, 1]} ; Janson, Guilherme ^[1]

Affiliation

^[1] Univ Sao Paulo, Bauru Dent Sch, Dept Orthodont, Alameda Octavio Pinheiro Brisolla 9-75, BR-17012901 Bauru, SP - Brazil

^[2] Univ Cient Sur, Sch Dent, Div Orthodont, Lima - Peru

^[3] Univ Cient Sur, Sch Dent, Div Oral & Maxillofacial Radiol, Lima - Peru

^[4] Univ Sao Paulo, Hosp Rehabil Craniofacial Anomalies, Bauru, SP - Brazil

• Document type: Journal article
• Source: AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS; v. 159, n. 1, p. 10-20, JAN 2021.
• Web of Science Citations: 0

Abstract

Introduction: This single-center 2-arm parallel randomized clinical trial aimed to compare the dentoskeletal effects of bonded spurs combined with posterior build-ups vs conventional bonded spurs in the treatment of anterior open bite malocclusion in the mixed dentition. Methods: Patients aged from 7 to 11 years with anterior open bite, recruited at a university orthodontic clinic, were randomly allocated into 2 groups. The experimental group consisted of patients treated with bonded spurs combined with posterior build-ups. The comparison group comprised patients treated with conventional bonded spurs. Lateral headfilms were obtained at pretreatment and after 12 months of treatment. The primary outcome was the change in the overbite. Randomization was performed using the Web site www.randomization.com. Sequentially numbered opaque and sealed envelopes were used for allocation concealment. Blinding was applicable for outcome assessment only. Intergroup comparisons were performed using t or Mann-Whitney U tests (P <0.05). Mean difference (MD) and 95% confidence interval (CI) were obtained. The experimental group included 24 patients (17 female, 7 male; mean age, 8.22 +/- 1.06 years) and the comparison group comprised 25 patients (14 female, 11 male; mean age, 8.30 +/- 0.99 years). Baseline demographic and cephalometric characteristics were similar between groups. After 12 months, all patients showed improvements. Both groups showed similar improvements of the overbite (MD, 0.00 mm; 95% CI, -0.92 to 0.91), similar slight decreases of the gonial (MD, 0.02 degrees; 95% CI, -1.11 to 1.15) and mandibular plane (MD, 0.15 degrees; 95% CI, -0.64 to 0.93) angles, and similar mandibular molar extrusion (MD, 0.14 mm; 95% CI, -0.27 to 0.56). The experimental group showed significantly smaller extrusion of the maxillary first molar than the comparison group (MD, -0.70 mm; 95% CI, -0.92 to -0.49). The other dentoskeletal variables showed similar changes without statistically significant intergroup differences. No serious harm was observed other than plaque accumulation around the spurs. Conclusions: Similar overbite increases and dentoskeletal changes were observed in both groups after 12 months of treatment. Although the experimental group showed significantly smaller extrusion of the maxillary molars, no greater counterclockwise rotation of the mandible than the comparison group was observed. Registration: This trial was registered at Clinicaltrials.gov (Identifier NCT03702881). The protocol was not published. Funding: This trial was financed in part by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - Brasil (CAPES), Finance Code 001; and by grants: no. 2017/06440-3, no. 2018/05238-9 and no. 2018/24003-2, Sao Paulo Research Foundation (FAPESP). (AU)

• FAPESP's process: 18/05238-9 - Anterior open bite treatment with bonded spurs associated with build-ups versus conventional bonded spurs: a randomized clinical trial
• Grantee: Guilherme dos Reis Pereira Janson
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/24003-2 - Three-dimensional changes in open bite patients treated with bonded spurs associated or not with posterior build-ups: a randomized clinical trial
• Grantee: Arón Aliaga Del Castillo
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 17/06440-3 - Anterior open bite treatment with bonded spurs associated with build-ups versus conventional bonded spurs: a randomized clinical trial
• Grantee: Arón Aliaga Del Castillo
• Support Opportunities: Scholarships in Brazil - Doctorate