Anterior Openbite Malocclusion in Adults: Treatment Stability and Patient Satisfaction

Thesis (Master's)--University of Washington, 2020Introduction: Anterior openbite (AOB) malocclusion is challenging for practitioners to both treat and maintain treatment outcomes. There are many orthodontic treatment and retention modalities used to treat AOB patients, but there is no consensus on which modalities are most successful or stable. This study aims to investigate the overall stability of AOB orthodontic treatment approximately one year after treatment in an adult population distributed across the United States, as well as factors that influence treatment stability. Factors that are associated with patients’ satisfaction with treatment are also described. Methods: Practitioners and their adult AOB patients were recruited through the National Dental Practice-Based Research Network. Patient dentofacial and demographic characteristics, practitioner demographic and practice characteristics, and factors relating to orthodontic treatment have been reported previously. Treatment stability was determined from end-of-treatment and post-treatment intraoral photographs. Patient satisfaction was determined from end-of-treatment and post-treatment questionnaires using five-point Likert-type scales and open-ended responses. Treatment was categorized into four main groups: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. The effect of extraction of teeth on treatment outcomes was also investigated. Retention type was categorized into Essix-style, Hawley-style, or bonded retainers and regimens were classified as full-time or part-time wear. Results: Retention data were collected from 112 patients who had been in retention for at least 9 months since the end of active treatment. The mean post-treatment time was 1.21 years (SD= 0.34 years). There were no statistically significant differences in stability between treatment groups. Overall 89% of patients maintained positive overbite (as measured on the right central incisors) and 65% maintained overlap of all incisors. Extractions exhibited a trend to be associated with higher stability. High satisfaction was reported by patients at one-year post-treatment. There were no significant differences in stability or satisfaction between retention types or regimens. Conclusion: The stability of orthodontic treatment in adult AOB patients who participated in this study was high, regardless of treatment modality. Stability tended to be higher for patients who had extractions than those who did not. Additionally, the satisfaction in adult AOB patients was also high, regardless of retention type and regimen