Treating anterior open bite

The Cochrane Central Register of Controlled Trials, Medline, Embase, LILACS (Latin American & Caribbean Health Sciences Literature) , Brazilian Bibliography of Odontology and SciELO. Ten Chinese journals were searched by hand and the bibliographies of papers were retrieved.

Randomised controlled trials (RCT) or quasi-RCT of orthodontic or orthopaedic treatments or both to correct anterior open bite in children were included.

Two review authors independently assessed the eligibility of all reports identified. Risk ratios (RR) and corresponding 95% confidence intervals (CI) were calculated for dichotomous data. The continuous data were expressed as described by the author.

Twenty-eight trials were potentially eligible, but only three RCT were included comparing treatments as follows: effects of Frankel's function regulator-4 (FR-4) with lip-seal training versus no treatment; repelling-magnet splints versus bite-blocks; and palatal crib associated with high-pull chincup versus no treatment. The study comparing repelling-magnet splints versus bite-blocks could not be analysed because the authors interrupted the treatment earlier than planned because of side-effects in four out of 10 patients. FR-4 associated with lip-seal training (RR, 0.02; 95% CI, 0.00-0.38) and removable palatal crib associated with high-pull chincup (RR, 0.23; 95% CI, 0.11-0.48) were able to correct anterior open bite. No study described the randomisation process nor sample size calculation; there was not blinding in the cephalometric analysis; and the two studies also evaluated two interventions at the same time.

There is weak evidence that the interventions FR-4 with lip-seal training and palatal crib associated with high-pull chincup are able to correct anterior open bite. Given that the trials included have potential bias, these results must be viewed with caution. Recommendations for clinical practice cannot be made based only on the results of these trials. More RCT are needed to elucidate the interventions for treating anterior open bite.