Original article
Relapse of anterior open bites treated with orthodontic appliances with and without orofacial myofunctional therapy

Preliminary findings were presented at the Annual Convention of the International Association of Orofacial Myology, June 17, 2005, in Vancouver, British Columbia, Canada.
https://doi.org/10.1016/j.ajodo.2008.07.016Get rights and content

Introduction

Closure and long-term retention of anterior open bites are significant concerns for orthodontists and their patients. In this study, we investigated the efficacy of orofacial myofunctional therapy (OMT) for maintaining closure of open bites in conjunction with orthodontic treatment.

Methods

The sample included 76 subjects with dental anterior open bites referred for OMT before, during, or after relapse of orthodontic treatment. The experimental cohort consisted of 27 subjects who received OMT and orthodontic treatment or retreatment. The control cohort comprised 49 subjects who had a history of orthodontic treatment with open-bite relapse. Overbite was evaluated by an OMT professional or orthodontist 2 months to 23 years after removal of the fixed appliances. Measurements were compared with t tests.

Results

Overbite relapse means were 0.5 mm (range, 0.0-4.0 mm) in the experimental group and 3.4 mm (range, 1.0-7.0 mm) in the control group, a difference that was clinically and statistically significant (P <0.0001).

Conclusions

This study demonstrated that OMT in conjunction with orthodontic treatment was highly effective in maintaining closure of anterior open bites compared with orthodontic treatment alone.

Section snippets

Material and methods

All subjects were referred by orthodontists to an OMT private practice because of dental anterior open bites and Angle Class I or Class II malocclusion. Open bite was measured to the nearest whole number as the vertical discrepancy between incisal edges of the mandibular central incisors and the lingual surface of the maxillary incisors or palate. No subject could contact the incisors by protruding the mandible, thus fitting the criterion of a true anterior open bite according to Ferguson.53

Results

Comparison of measurements made by orofacial myofunctional therapists vs orthodontists at the follow-up showed the 2 did not differ statistically. The relapse differences between the experimental cohort (treated with orthodontics and OMT) and control cohort (treated with orthodontics alone) as shown by the t tests were highly statistically significant (P <0.0001; Table II). The distribution of relapse of the control subjects was relatively symmetric (Fig 2; range, 1-7 mm; mean, 3.4 ± 1.3 mm).

Discussion

The results of this study show a clear difference between the outcomes of subjects with anterior open bites when treated with orthodontics alone compared with those treated with orthodontics and OMT. A key finding was that relapse in the experimental cohort treated with orthodontics and OMT (0.48 ± 0.8 mm) was significantly less than that in the control cohorts treated with orthodontics alone (3.38 ± 1.3 mm; P <0.0001; Table II). In addition to the 23 subjects who received OMT before or during

Conclusions

  • 1.

    OMT with orthodontic treatment was efficacious in closing and maintaining closure of dental open bites in Angle Class I and Class II malocclusions, and it dramatically reduced the relapse of open bites in patients who had forward tongue posture and tongue thrust. Correcting low forward tongue posture and tongue thrust swallows minimized the risk of orthodontic relapse.

  • 2.

    Speech errors and oral habits were associated with relapse but were often correctable with OMT. Retention of speech errors did

References (59)

  • C.D. Alexander

    Open bite, dental alveolar protrusion, Class I malocclusion: a successful treatment result

    Am J Orthod Dentofacial Orthop

    (1999)
  • J.S. Cooper

    A comparison of myofunctional therapy and crib appliance effects with a maturational guidance control group

    Am J Orthod

    (1977)
  • W.J. Straub

    Malfunction of the tongue, part I

    Am J Orthod

    (1960)
  • W.J. Straub

    Malfunction of the tongue, part II

    Am J Orthod

    (1961)
  • W.J. Straub

    Malfunction of the tongue, art III

    Am J Orthod

    (1962)
  • C.E. Weiss et al.

    A remedial program for tongue-thrust

    Am J Orthod

    (1972)
  • J.S. Dahan et al.

    Effects of bite raising and occlusal awareness on tongue thrust in untreated children

    Am J Orthod Dentofacial Orthop

    (2003)
  • C.F. Gugino et al.

    Unlocking orthodontic malocclusions: interplay between form and function

    Semin Orthod

    (1998)
  • A. Klocke

    Ask us

    Am J Orthod Dentofacial Orthop

    (2003)
  • S.I. Robb et al.

    Effectiveness and duration of orthodontic treatment in adults and adolescents

    Am J Orthod Dentofacial Orthop

    (1998)
  • F.R. Beckwith et al.

    An evaluation of factors affecting duration of orthodontic treatment

    Am J Orthod Dentofacial Orthop

    (1999)
  • S.S. Efstratiadis

    An American Board of Orthodontics case report. Treatment of an open bite malocclusion

    Am J Orthod Dentofacial Orthop

    (1990)
  • T.F. Dennison et al.

    Stability of maxillary surgery in openbite versus nonopenbite malocclusions

    Angle Orthod

    (1989)
  • T.J. Hoppenreijs et al.

    Afdeling mond-en kaakchirurgie, Academisch Ziekenhuis te Nijmegen

    Ned Tijdschr Tandheelkd

    (1992)
  • F.M. Lo et al.

    Effect of presurgical incisor extrusion on stability of anterior open bite malocclusion treated with orthognathic surgery

    Int J Adult Orthod Orthognath Surg

    (1998)
  • R.A. Gile

    A longitudinal cephalometric evaluation of orthodontically treated anterior openbites

    (1972)
  • D. Burford et al.

    The causes, diagnosis and treatment of anterior open bite

    Dent Update

    (2003)
  • D.M. Sarver

    Commentary: Huang GJ, Justus R, Kennedy DB, Kokich VG. Stability of anterior openbite treated with crib therapy

    Angle Orthod

    (1990)
  • C. Katsaros et al.

    Anterior open bite malocclusion: a follow-up study of orthodontic treatment effects

    Eur J Orthod

    (1993)
  • Cited by (75)

    • Short-term stability of anterior open bite treatment with clear aligners in adults

      2023, American Journal of Orthodontics and Dentofacial Orthopedics
    View all citing articles on Scopus

    Partially funded by the Committee for Research on Orofacial Myology (John P. Howland, chairman), which ceased operation and donated its treasury to the Portland State University Foundation.

    The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

    View full text