Anterior vs. Posterior Bite Raisers: Assessment of Quality of Life and Pain Experience

Objective: This retrospective study aims to assess the impact of bite-raising on patients' quality of life and to compare the outcomes of anterior versus posterior build-ups. Materials and Methods: A total of 94 young adolescents treated with fixed orthodontic were selected and divided into two groups: the anterior bite raisers group (ABG) and the posterior bite raisers group (PBG). To enable comparison with untreated individuals, a control group (CG) of 50 subjects was also included. Pain intensity was assessed using a Visual Analog Scale (VAS), while oral health-related quality of life (OHRQoL) was measured through the OHIP-14 questionnaire (Italian validated version) before treatment and during each appointment for the first 3 months after build-ups placement. Results: Patients undergoing orthodontic treatment without bite raisers (CG) reported lower OHIP-14 scores compared to those with anterior (ABG) and posterior (PBG) bite raisers. In both ABG and PBG, the most commonly reported side effects included difficulty eating, oral pain, and feelings of embarrassment in social situations-similar to those reported by the control group. However, participants in the ABG also reported challenges in pronouncing certain words. Furthermore, the ABG experienced higher levels of physical pain, physical disability, and psychological discomfort compared to both the PBG and CG. Patients in the ABG reported more build-ups detachments or breakages than patients in PBG (ABG 32% vs. PBG 18%, p < 0.01). Build-ups were removed due to adequate overbite correction significantly before in the ABG (4.2 ± 0.9 months) than in the PBG (6.1 ± 1.4 months, p < 0.01). Conclusions: Anterior bite raisers have a significantly greater impact on patients' quality of life compared to posterior bite raisers, leading to increased difficulties in eating and speech, higher levels of physical pain and disability, greater psychological discomfort, and more intense pain following build-ups placement.