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Intervention Review

Orthodontic and orthopaedic treatment for anterior open bite in children

  1. Débora A Lentini-Oliveira1,*,
  2. Fernando R Carvalho1,
  3. Qingsong Ye2,
  4. Junjie Luo2,
  5. Humberto Saconato3,
  6. Marco Antonio C Machado4,
  7. Lucila BF Prado1,
  8. Gilmar F Prado5

Editorial Group: Cochrane Oral Health Group

Published Online: 18 APR 2007

Assessed as up-to-date: 13 FEB 2007

DOI: 10.1002/14651858.CD005515.pub2


How to Cite

Lentini-Oliveira DA, Carvalho FR, Ye Q, Luo J, Saconato H, Machado MAC, Prado LBF, Prado GF. Orthodontic and orthopaedic treatment for anterior open bite in children. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005515. DOI: 10.1002/14651858.CD005515.pub2.

Author Information

  1. 1

    Universidade Federal de São Paulo, Internal Medicine Department, São Paulo, Vergueiro, Brazil

  2. 2

    West China College of Stomatology, Department of Orthodontics, Chengdu, Sichuan Province, China

  3. 3

    Federal University of Rio Grande do norte, Department of Medicine, São Paulo, Vila Clementino, Brazil

  4. 4

    Universidade Federal de São Paulo, Department of Neurology and Internal Medicine, São Paulo, Paraíso, Brazil

  5. 5

    São Paulo, Aclimação, Brazil

*Débora A Lentini-Oliveira, Internal Medicine Department, Universidade Federal de São Paulo, Tuiuti -22, Sorocaba, São Paulo, Vergueiro, 18035-340, Brazil. deblentini@terra.com.br.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 APR 2007

SEARCH

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Anterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. The aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this malocclusion, but interventions are not supported by strong scientific evidence.

Objectives

The aim of this systematic review was to evaluate orthodontic and orthopaedic treatments to correct anterior open bite in children.

Search methods

Search strategies were developed for MEDLINE and revised appropriately for the following databases: Cochrane Oral Health Group Trials Register; CENTRAL (The Cochrane Library 2005, Issue 4); PubMed (1966 to December 2005); EMBASE (1980 to February 2006); LILACS (1982 to December 2005); BBO (1986 to December 2005); and SciELO (1997 to December 2005). Chinese journals were handsearched and the bibliographies of papers were retrieved.

Selection criteria

All randomised or quasi-randomised controlled trials of orthodontic or orthopaedic treatments or both to correct anterior open bite in children.

Data collection and analysis

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

Main results

Twenty-eight trials were potentially eligible, but only three randomised controlled trials were included comparing: 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 due to side effects in four of ten patients.
FR-4 associated with lip-seal training (RR = 0.02 (95% CI 0.00 to 0.38)) and removable palatal crib associated with high-pull chincup (RR = 0.23 (95% CI 0.11 to 0.48)) were able to correct anterior open bite.
No study described: randomisation process, sample size calculation, there was not blinding in the cephalometric analysis and the two studies evaluated two interventions at the same time. These results should be therefore viewed with caution.

Authors' conclusions

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 randomised controlled trials are needed to elucidate the interventions for treating anterior open bite.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Orthodontic and orthopaedic treatment for anterior open bite in children

Interventions were able to correct anterior open bite but this was based on data from two studies that have problems in their quality.
Open bite is characterised by a lack of vertical overlap of the upper and lower incisors. This problem has several possible causes such as mouth breathing, sucking habits, alteration of development of jaw and maxilla. It can make speech, swallowing, mastication and aesthetics difficult. Several treatments have been used to correct anterior open bite. The review authors evaluated three studies with the following treatments: Frankel's function regulator-4 (FR-4) with lip-seal training, palatal crib with chincup, and repelling-magnet splints versus bite-blocks. This last study could not be analysed because the author interrupted the treatment earlier than planned due to side effects.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

兒童前牙開咬之齒列矯正(Orthodontic)和齒顎矯正(orthopaedic)治療

前牙開咬的發生,常是因為上下門牙缺乏垂直性的重疊。而其致病原因為多因子的,包括口腔習慣,不良的生長形式,因為過大的淋巴組織所致的口呼吸。而有許多的治療方式被提出來改正此種不良咬合,但是這些治療都沒有強烈的科學根據佐証

目標

因此本系統性回顧的目標,就是要去評估用來兒童前牙開咬的齒列矯正和齒顎矯正的治療方法

搜尋策略

而本篇的研究策略是經由MEDLINE發展而來,和經過下列資料庫的適當修訂而成,像是Cochrane Oral Health Group Trails Register, CENTRAL(The Cochrane Library 2005年第四期), Pubmed(1966年到2005年12月),EMBASE(1980年到2006年2月),Lilacs(1982年到2005年12月),Brazilian Bibliography of Odontology (BBO) (1986年到2005年12月),還有SciELO(1997年到2005年12月)。中文的論文部分則是經由手動方式來作搜尋,且同時檢索論文的參考書目。

選擇標準

所有隨機和半隨機的控制試驗,針對改正兒童前牙開咬,包括齒列矯正或齒顎矯正或合併的治療方式。

資料收集與分析

二個各別獨立作業的審查者,去評估所有要辦別的論文其合適性,風險比例(RSs)和所對應的95%信賴間隔(CIs)都被計算成分支資料。而連續性的資料則由作者陳述。

主要結論

有28個合適試驗,但只有3個隨機控制實驗被選取,其中包括比較有無使用第四代的法蘭克功能性調節器伴隨唇閉合訓練的效果,相斥的磁鐵咬合板和bite block的比較及有無使用高位chincap伴隨palatal crib的比較。而比較使用相斥的磁鐵咬合板和咬合塊的研究則不能被分析,因為作者在十個病人中的四個,因為其副作用的出現,而比預期更早中斷治療。而使用第四代法蘭克福功能性調節器伴隨唇閉合訓練(RR = 0.02 (95% CI 0.00 to 0.38))和使用高位chincap合併活動性plaltal crib都可以用來矯正前牙的咬合開咬。沒有研究描述:隨機的過程,樣本大小的計算,而且在側顱分析沒有盲性處理,有兩個研究在相同時間評估兩個治療方式,這些結果應該要小心的檢視。

作者結論

對於使用第四代法蘭克福功能性調節器伴隨唇閉合訓練與使用高位Chincap的palatal crip是否能改善前牙開咬的証據是很薄弱的。而且試驗方法都有潛在性的誤差,因此,其結果必需小心的檢視,建議改為“而臨床操作不能只憑這些結果來決定,需要更多的隨機控制試驗來說明治療前牙開咬的方法。

翻譯人

本摘要由臺灣大學附設醫院陳易聖翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

治療方法可以矯正前牙開咬,但這個是基於從二個有品質問題的研究資料而來,開咬的特色是缺乏上下門牙的垂直重疊。可能的原因包括口呼吸,吸吮習慣,上下顎生長的改變等。開咬可以造成說話,吞嚥,咀嚼和美觀的困難。一些治療已經使用來矯正前牙開咬。而檢視的作者評估三個研究,其治療方式如下:使用第四代的法蘭克福功能性調節器伴隨嘴唇閉合訓練,使用chincap和palatal crib,帶有相斥磁力的咬合板和biteblock。而最後一篇研究不能被分析,因為作者在預期的治療時間之前,就終止治療,因為有副作用的產生