Multidisciplinary approach in the anterior open bite using a McNamara expander with palatal crib during mixed dentition stage: A case report

Wendes Dias Mendes1Orcid, Paôla Caroline da Silva Mira2Orcid, Paula Regina Ávila Silvan3Orcid, Patrícia Maria Monteiro4Orcid, Mirian Aiko Nakane Matsumot5Orcid, Maria Bernadete Sasso Stuani6Orcid

Highlights

Pediatric dentists need to be aware of the multidisciplinary work involved in the treatment of anterior open bite as a result of its multifactorial etiology.
This case report presents an orthodontic treatment option based on the elimination of confounding factors during diagnosis of the malocclusion.
This article seeks to delegate competencies regarding the treatment of anterior open bite since the dentist is not able to fully intervene in some circumstances.

Abstract

Open bite can be defined as an absence of occlusion, most frequently located in the anterior region of dental arches and its etiology is multifactorial. We present a clinical case of an 8 years and 10 months child presenting an anterior open bite (AOB) with transverse maxillary deficiency caused by tongue thrust during mixed dentition. The malocclusion was corrected by means of a McNamara expander with a palatal crib jointly with the association of speech therapy for tongue repositioning, and otolaryngology to treat adenoid hypertrophy due to its correlation with AOB. The multidisciplinary approach was effective in correcting the malocclusion with stable results after 2 years post-treatment.

Keywords: Interceptive Orthodontics; Malocclusion; Open Bite

Author Affiliations

  1. Master’s Degree Student, Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Brazil
  2. PhD Student, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Brazil ( Correspondence: paola.mira@usp.br )
  3. PhD Student, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Brazil
  4. Postdoctoral student, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Brazil
  5. Associate Professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Brazil
  6. Associate Professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Brazil
  1. Moyers RE. Handbook of orthodontics. 4th ed. Chicago: Year Book Medical Publishers; 1988
  2. Almeida RR, Ursi WJS. Anterior open bite; etiology and treatment. Oral Health 1990;80:27-31
  3. Cangialosi TJ. Skeletal morphologic features of previous open bite. Am J Orthod 1984;85:28-36
  4. Tavares CAE, Allgayer S. Open bite in adult patients. Dental Press J Orthod 2019;24:69-78
  5. Reis MJ, Pinheiro CN, Malafaia M. Treatment of anterior open bite: case report. Rev Clin Orthodon Dental Press 2007;6:88-96
  6. Kline SN, Shensa DR, Kahn M. Skeletal open bite-surgical management: report of case. J Oral Surg 1970;28:791-794
  7. Nahoum HI. Previous open-bite: a cephalometric analysis and suggested treatment procedures. Am J Orthod 1975;67:523-521
  8. Feres MF, Abreu LG, Insabralde NM, de Almeida MR, Flores-Mir C. Effectiveness of open bite correction when managing deleterious oral habits in growing children and adolescents: A systematic review and meta-analysis. Eur J Orthod 2017;39:31-42
  9. Espinosa DG, Moreira PEO, Sousa AS, Flores-Mir C, Normando D. Stability of anterior open bite treatment with molar intrusion using skeletal anchorage: a systematic review and meta- analysis. Prog Orthod 2020;21:35-37
  10. Akan B, Ünal BK, Şahan AO, Kızıltekin R. Evaluation of anterior open bite correction in patients treated with maxillary posterior segment intrusion using zygomatic anchorage. Am J Orthod Dentofacial Orthop 2020;158:547-554
  11. De Rossi M, De Rossi A, Abrão J. Skeletal alterations associated with the use of bonded rapid maxillary expansion appliance. Braz Dent J 2011;22:334-339
  12. Scheffler NR, Proffit WR, Phillips C. Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint. Am J Orthod Dentofacial Orthop 2014;146:594-602
  13. Haas AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthod 1961;31:73–90
  14. Tanny L, Huang B, Shaweesh A, Currie G. Characterization of anterior open bite in primary school-aged children: a preliminary study with artificial neural network analysis. Int J Paediatr Dent 2021;31:576-582
  15. Giuntini V, Franchi L, Baccetti , T, Mucedero M, and Cozza P. Dentoskeletal changes associated with fixed and removable appliances with a crib in open- bite patients in the mixed dentition . Am J Orthod Dentofacial Orthop 2008;133:77-80
  16. Flores-Ysla A, Arriola-Guillén LE, Rodríguez-Càrdenas YA, Ruíz-Mora GA, Aliaga-Del Castillo A, Janson G. Skeletal open bite cranial base characteristics in young Latin-American individuals with class I, II and III malocclusions: An observational study. Int Orthod 2020;18:237-245
  17. Gutiérrez DAR, Garzón JS, Franco JQ, Botero MP. Previous open bite and its relationship with dental arch dimensions and tongue position during swallowing and phonation in aged individuals 8–16 years: A retrospective case–control study. Int Orthod 2021;19:107-116
  18. Sonis A, Ackerman M. E-space preservation. Angle Orthod 2011;81:1045-1049
  19. Lopes BK, Scheicher GV, Matsumoto MA, Romano FL. Rapid palatal expansion and utilization of e-space in mixed dentition: mechanics that helps in the corrective orthodontic treatment. Int J Clin Pediatr Dent 2021;14:133-139
  20. Kawamura M, Nojima K, Nishii Y, Yamaguchi H. A cineradiographic study of deglutitive tongue movement in patients with anterior open bite. Bull Tokyo Dent Coll 2003;44:133–139
  21. Evcimik MF, Dogru M , Cirik AA, Nepesov MI. Adenoid hypertrophy in children with allergic disease and influential factors. Int J Pediatr Otorhinolaryngol 2015;79:694–697
  22. Niedzielski A, Chmielik LP, Kasprzyk A, Stankiewicz T, Mielnik-Niedzielska G. Health-Related Quality of Life Assessed in Children with Adenoid Hypertrophy. Int J Environ Res Public Health 2021;18:8935-8937
  23. Łapińska I, Zawadzka-Głos L. Adenoid and tonsils hypertrophy−symptoms and treatment. New Med 2016;20:103-106
  24. Solmaz F, Aşcıoğlu ME, Durgut O, Dikici O, Haksever M, Akduman D. Are nasal steroids effective in children with adenoid hypertrophy? European Res J 2019;5:311-318
  25. Adkins MD, Nanda RS, Currier GF. Arch perimeter changes on rapid palatal expansion. Am J Orthod Dentofacial Orthop 1990;97:194-199
  26. Wendling L, Mcnamara J, Franchi L, Baccetti T. A Prospective Study of the Short- term Treatment Effects of the Acrylic-splint Rapid Maxillary Expander Combined with the Lower Schwarz Appliance. Angle Orthod 2005;75:7-14
  27. Pisani L, Bonaccorso L, Fastuca R, Spena R, Lombardo L, Caprioglio. Systematic review for orthodontic and orthopedic treatments for previous open bite in the mixed dentition. Orthod Prog 2016;17:28-32

Article Info

Contemp Pediatr Dent 2021:2(3):166-175

Received: 22 September 2021

Accepted: 9 November 2021

Online First: 19 November 2021

332 views

Full Text

File Downloads
pdf CPD_2021_83 1294

How to Cite

				
					Wendes Dias Mendes, Paôla Caroline da Silva Mira, Paula Regina Ávila Silvano, Patrícia Maria Monteiro, Mirian Aiko Nakane Matsumoto, Maria Bernadete Sasso Stuani. Multidisciplinary approach in the anterior open bite using a McNamara expander with palatal crib during mixed dentition stage: A case report. Contemp Pediatr Dent 2021:2(3):161-175. 
				
			

Related Articles

Share Article

Under a Creative Commons license