Treatment outcomes and short-term stability in adult anterior openbite patients treated with or without extractions: a National Dental Practice-Based Research Network study.

Abstract

Objectives: To investigate whether extractions in adult anterior openbite (AOB) patients lead to improved treatment outcomes and better short-term stability.

Materials and methods: Records of extraction (EXT) and nonextraction (NE) adult patients were identified from all patients treated with fixed appliances through the National Dental Practice-Based Research Network. Photographic Openbite Severity Index was used to assess treatment success and stability. Skeletal, dental, and soft tissue treatment outcomes were evaluated using cephalometric analysis.

Results: Pretreatment and posttreatment records were collected for 115 patients. Thirty-three were treated with extractions; 82 were treated without extractions. The EXT group was younger, more crowded, and had less previous orthodontic treatment. Success rate of AOB correction in the EXT group was slightly higher (97%) than the NE group (92%) but not statistically different. No significant differences were observed in skeletal outcomes. The EXT group exhibited more lingual tipping and posterior movement of maxillary and mandibular incisors and less extrusion of mandibular incisors. Dental changes in the EXT group were associated with increased nasolabial angle and lip retraction. The small number of patients with AOB relapse did not provide enough power to identify differences in stability between the two groups.

Conclusions: Orthodontists have high success correcting AOB with or without extractions. The EXT group displayed more retraction and lingual tipping of incisors as well as increased retraction of soft tissues. Stability of AOB closure was more than 90% for both groups after 1 year, with marginal increases in stability after extractions.