Molar Intrusion in Open-bite Adults Using Zygomatic Miniplates.

Abstract

The aim of this study is to evaluate the skeletal, dental and soft tissue changes that arise after intrusion of the maxillary molars using zygomatic miniplates in adult skeletal anterior open bite patients. In addition to measuring the amount and rate of molar intrusion; with special emphasis on changes in the axial inclination of the intruded molars. The study group was composed of 13 anterior open bite patients (mean age 18 years, 8 months ± 2 years, 2 months) with posterior dentoalveolar excess. Mini-plates were placed in the zygomatic buttress bilaterally. The upper arch was segmentally leveled and a double Trans-Palatal Arch (TPA) was bonded. Closed NiTi coil spring was placed bilaterally between the book of the mini-plate just mesial and distal to the first molar buccal tube applying intrusive force of 450 gper side. Lateral and posteroanterior cephalograms were taken before intrusion (T1: post upper segmental leveling) and after intrusion (T2). Comparison between means before and after the intrusion was done using Wilcoxon Signed Ranks test (WSRT). Mandibular autorotation followed the molar intrusion, SNB and SN-Pog angles significantly increased while the ANB, MP-SN angle and N-S-Gn angle significantly decreased. The mean amount of accomplished molar intrusion was 3.1mm ± 0.74mm, with a rate of 0.36mm per month ± 0.08mm per month and a bite closure of 6.55mm ± 1.83mm. There was no significant buccal tip in the right and left molars upon intrusion. Conclusion: Miniplates zygomatic anchorage can be used effectively for skeletal open bite correction through posterior dento-alveolar intrusion. Intrusion of the posterior teeth with skeletal anchorage induced counterclockwise rotation of the mandible and, as a consequence, corrected the anteroposterior intermaxillary relationship with a dramatic improvement in the facial soft tissue convexity.