Anterior open bite treated with a palatal crib and high-pull chin cup therapy. A prospective randomized study

The aim of this prospective randomized clinical study was to cephalometrically investigate the dentoalveolar and soft tissue changes produced by a removable appliance with a palatal crib associated with high-pull chin cup therapy in children with an Angle Class I anterior open bite (AOB) malocclusion. Thirty children (8 males and 22 females) with an initial mean age of 8.3 years and a mean AOB of 4.1 mm were treated with a removable appliance composed of a palatal crib associated with chin cup therapy for 12 months. A control group of 30 individuals (7 males and 23 females) closely matched for age, initial mean age 8.6 years, gender, and ethnicity with a mean AOB of 4.6 mm was followed without treatment. The measurements (means and standard deviations) were statistically analysed using a paired t-test. The results showed no significant differences in the level of molar eruption or in lower anterior face height, suggesting that the vertical control expected from the chin cup therapy did not occur. Dentoalveolar changes at the anterior region were evident, with statistically significant extrusion, retrusion, and lingual tipping of the maxillary and mandibular incisors (P < or = 0.05). However, these hard tissue changes did not imply soft tissue changes and the variables related to the soft profile were not statistically significantly different between the groups. The dentoalveolar changes at the anterior region of the dental arches were mainly responsible for closure of the AOB in patients treated in the mixed dentition.