Anterior open bite :causative factors and diagnosis

Abstract

ABSTRACT The real difficulty behind the treatment of open bite is the easy relapse, for it has a multifactorial nature. Aim: The aim of this study is to compare the reliability of two differential ways in the diagnosis of the open bites, looking out for the causative factors, aiding in more specific treatment plan and less relapse. Materials and Methods: A sample of 53 anterior open bite cases, all in the post–pubertal and early adulthood period (17–25 years), was assessed twice, clinically and cephalometrically. Due to clinical assessments, the whole sample was grouped as “Morphogenetic” and “Functional” groups. The same sample was also cephalometrically assessed and grouped as “Skeletal” and “Dento–alveolar” using mandibular plane angle, suspected that the morphogenetic group clinically matches the cephalometrically assessed skeletal group in number; also the functional group clinically matches the cephalometrically assessed Dento–alveolar group in number. Student’s t–test indicated a weak agreement between clinical judgment and cephalometric evaluation (p < 0.001). Results: Unexpectedly, the sample which assessed as skeletal hyper–divergent cephalometrically, half of it in fact was classified as functional cases clinically. This misdiagnosis may lead to inadequate treatment plan, in which relapse should be highly expected. Conclusions: These findings highlighted that, it is not enough to depend on “cephalometric evaluation” alone to design the treatment plan for open bite cases. Clinical evaluation is also important to point out the real causative factors for designing an adequate treatment plan (i.e., rehabilitation of the soft tissue bad habits, when needed) to reduce the prevalence of relapse