Title Surgical and Nonsurgical Treatment Have Comparable Stability in the Treatment of Anterior Open-Bite Malocclusion
Clinical Question In patients with anterior open-bite malocclusions, does surgical treatment, compared to nonsurgical treatment increase the stability of the outcome when observed at follow-up?
Clinical Bottom Line For patients with anterior open-bite malocclusions, on average 2.5mm non-surgical treatment is almost equally effective as surgical treatment in maintaining positive over-bite. This is supported by a meta-analysis of 21 case series. Both treatments succeeded in closing anterior open-bites in greater than 75% of the cases. However, due to the different clinical populations, no direct comparative effectiveness was possible and these results should be viewed with caution.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
21300243Greenlee/2011Patients with -3mm of anterior open-bite malocclusion on averageMeta-Analysis of case series studies
Key resultsThis meta-analysis narrowed abstracts from 105 abstracts down to 21 articles. Surgery patients averaged 23 years old and the mean age of the non-surgical group was 16 years old. The average openbite was -2.5mm prior to treatment, and the average closure of the anterior open bites was +1.6mm for the surgical group and +1.3mm for the nonsurgical group. At follow up, relapse of the surgical group reduced their overbite to +1.3 mm and +0.8mm for the nonsurgical group. Stability of both groups was over 75% for the treatment of anterior open bite malocclusions.
Evidence Search Anterior open-bite treatment stability
Comments on
The Evidence
Validity: At first, this meta-analysis could lead practitioners to believe that surgical and non-surgical closure of anterior open bite malocclusions are equally effective. The surgical and nonsurgical treatment provided were not explained. The authors even claim that this meta-analysis must be regarded with caution. Perspective: More studies, which take into account factors of the anterior open bite diagnosis would provide us better research on this subject. This study is a good start to the research on anterior open bite treatment stability.
Applicability These results can be deceiving, leading an orthodontist to attempt closing all open bite malocclusions with their preferred surgical or nonsurgical approach. Not all open bite malocclusions can be effectively treated with the same mechanics. Each practitioner needs to thoroughly diagnose each patient and treat the malocclusion to their best, with the patient’s specific goals leading the treatment.
Specialty (Oral Surgery) (Orthodontics)
Keywords Anterior open bite, stability, retention
ID# 2790
Date of submission 12/03/2014
E-mail farnsworthk@uthscsa.edu
Author Kevin Farnsworth, DDS
Co-author(s) e-mail
Faculty mentor Clarence C. Bryk, DDS, MS
Faculty mentor e-mail brykc@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available