Comparing skeletal and dentoalveolar effects of fixed palatal crib and bonded spurs in early management of anterior open bite associated with non-nutritive sucking habits: a randomized clinical trial.

Purpose: To evaluate the effects of fixed palatal cribs and bonded spurs on skeletal and dentoalveolar parameters during treatment of anterior open bite associated with non-nutritive sucking habits.

Methods: This randomized clinical trial involved 30 children aged 6-11 years with an anterior open bite ≥ 1 mm. Participants were assigned randomly to two groups: fixed palatal crib (FPC, n = 15, mean age 8.6 years) and bonded spurs (BS, n = 15, mean age 8.3 years). Digital bio-models and lateral cephalometric images were obtained at baseline and after 12 months of treatment. Paired and independent t tests were used for intra- group and inter-group comparisons, respectively.

Results: The FPC group had significantly greater overbite correction than the BS group (1.22 ± 2.18 mm, p = 0.00387), with 73.33% achieving a positive overbite compared to 6.67% in the BS group. The FPC group also showed significantly higher increases in mandibular arch perimeter (2.57 ± 0.79 mm, p = 0.00314), maxillary arch length (1.56 ± 0.35 mm, p = 0.00013), mandibular arch length (1.62 ± 0.30 mm, p = 0.00001), and intermolar width (0.71 ± 0.24 mm, p = 0.00001). Cephalometric findings showed greater reduction in the lower central incisor mandibular plane angle (6.75° ± 1.65°, p = 0.00032) and a corresponding increase in the interincisal angle (6.12° ± 2.61°, p = 0. 02654), while skeletal measurements showed no statistically relevant variation between the two groups.

Conclusion: The fixed palatal crib appliance was more effective than bonded spurs in managing anterior open bite in growing patients, mainly via dentoalveolar changes, (such as incisor retroclination), without affecting skeletal parameters.