ABSTRACT
Background:
Open bite is a common orthodontic malocclusion that can have functional and aesthetic implications. Traditional orthodontic treatments have been used to correct open bites, but the effectiveness of Invisalign, a clear aligner therapy, in open bite correction remains a topic of interest
Materials and Methods:
A retrospective analysis was conducted on a cohort of 50 patients with open bites who underwent Invisalign treatment. Pre-treatment and post-treatment records, including cephalometric radiographs, dental models, and clinical photographs, were assessed. The open bite was defined as a negative overbite greater than 2 mm. Treatment duration, number of aligners used, and patient compliance were also recorded. Statistical analysis, including paired t-tests and subjective patient feedback, was employed to evaluate the treatment outcomes.
Results:
The mean pre-treatment open bite was -3.5 mm (SD = 1.2), and the mean treatment duration was 18 months (SD = 2.5). On average, patients received 24 sets of aligners (SD = 4.1) during the treatment. Post-treatment evaluation showed that the mean overbite improved to + 1.5 mm (SD = 0.8), indicating successful open bite correction. The paired t-test revealed a statistically significant difference between pre-treatment and post-treatment open bite measurements (P < 0.001). Patient satisfaction was high, with 90% of participants reporting improved aesthetics and comfort
Conclusion:
Invisalign treatment demonstrates effectiveness in correcting open bites, with statistically significant improvements in overbite measurements.
KEYWORDS: Clear aligners, Invisalign, malocclusion, open bite, orthodontic treatment, overbite correction
INTRODUCTION
Open bite is a common orthodontic malocclusion characterized by a lack of vertical overlap between the upper and lower teeth when the jaws are in occlusion.[1] This condition can lead to functional issues such as speech difficulties, masticatory problems, and compromised aesthetics, which can significantly impact an individual’s quality of life.[2,3] Traditional orthodontic treatments, including fixed appliances and extractions, have been utilized to correct open bites.[4] However, these approaches often require prolonged treatment durations and can be associated with patient discomfort and compliance issues.
In recent years, Invisalign, a clear aligner therapy, has emerged as an alternative treatment modality for various orthodontic conditions.[5] Invisalign offers several advantages over traditional braces, including improved aesthetics, increased comfort, and better patient compliance due to its removable nature.[6] While Invisalign has been widely used for the correction of various malocclusions, its effectiveness in treating open bites remains a subject of investigation.
Several studies have reported positive outcomes with Invisalign treatment for open bite correction.[7] However, the evidence in this area is still evolving, and there is a need for further research to comprehensively assess the efficacy of Invisalign in addressing open bite malocclusions. This study aims to contribute to the existing body of knowledge by evaluating the effectiveness of Invisalign treatment on open bite correction through a retrospective analysis of patient records.
MATERIALS AND METHODS
Study design and patient selection
This retrospective study involved the review of patient records from a private orthodontic practice specializing in Invisalign treatment. The study was conducted by ethical guidelines and received approval from the Institutional Review Board. Informed consent was obtained from all patients for the use of their records in this research.
Inclusion criteria
Patients diagnosed with open bite malocclusion.
Patients who underwent Invisalign treatment for open bite correction.
Availability of complete pre-treatment and post-treatment records, including cephalometric radiographs, dental models, and clinical photographs.
Exclusion criteria
Patients with incomplete or inadequate records.
Patients who received additional orthodontic interventions concurrently with Invisalign treatment.
Data collection
Patient records were systematically reviewed, and the following data were collected:
Demographic information: Age, gender, and initial date of treatment.
Clinical assessment: Pre-treatment and post-treatment overbite measurements recorded in millimeters.
Treatment details: Total duration of Invisalign treatment (in months), number of sets of aligners used, and any mid-course corrections.
Patient compliance: Documentation of any instances of non-compliance, including missed appointments or extended aligner wear times.
Radiographic analysis
Cephalometric radiographs were traced and analyzed using standardized cephalometric landmarks. The ANB (A point, nasion, B point) angle and other relevant measurements were used to assess skeletal changes associated with open bite correction.
Statistical analysis
Statistical analysis was performed using SPSS 23 software (statistical package for social sciences). Paired t-tests were conducted to compare pre-treatment and post-treatment overbite measurements. Descriptive statistics were used to summarize demographic and treatment-related data. The level of significance was set at P < 0.05.
RESULTS
The mean age of the patients was 26.5 years, with a standard deviation (SD) of 4.3 years. The age range of participants in the study varied from 19 to 34 years. Among the participants, 32 were female, and 18 were male.
Table 1 outlines the treatment details for the study cohort. On average, the Invisalign treatment duration was 18.2 months, with a standard deviation of 2.1 months. The range of treatment durations varied from 15 to 22 months. Participants received an average of 24.7 sets of aligners during their treatment, ranging from 20 to 30 sets. Mid-course corrections were performed for five patients (N = 5), accounting for 10% of the sample. Approximately 12% of patients reported compliance issues, which included missed appointments and prolonged aligner wear times.
Table 1.
Treatment details
| Treatment parameter | Mean±SD (range) |
|---|---|
| Treatment Duration (months) | 18.2±2.1 (15-22) |
| Number of Aligner Sets | 24.7±3.5 (20-30) |
| Mid-Course Corrections | 5 (n=5) |
| Compliance Issues (%) | 12% |
Table 2 presents the pre-treatment and post-treatment overbite measurements in millimeters (mm). Before treatment, the mean overbite was -3.5 mm with a standard deviation of 1.2 mm. After Invisalign treatment, the mean overbite improved to + 1.6 mm, with a standard deviation of 0.9 mm. The change in overbite measurements from pre-treatment to post-treatment was statistically significant (P < 0.001) as determined by paired t-tests.
Table 2.
Pre-treatment and post-treatment overbite measurements (mm)
| Measurement point | Pre-treatment mean±SD | Post-treatment mean±SD |
|---|---|---|
| Overbite | -3.5±1.2 | +1.6±0.9 |
Table 3 summarizes the results of the patient satisfaction survey. The majority of patients reported high satisfaction levels with Invisalign treatment. Approximately 90% of patients were very satisfied with the aesthetics of their treatment, and 86% were very satisfied with the comfort. Overall, 88% of patients were very satisfied with their overall treatment experience.
Table 3.
Patient satisfaction survey results
| Aspect of treatment | Very satisfied (%) | Somewhat satisfied (%) | Neutral (%) | Somewhat dissatisfied (%) | Very dissatisfied (%) |
|---|---|---|---|---|---|
| Aesthetics | 90% | 8% | 2% | 0% | 0% |
| Comfort | 86% | 12% | 2% | 0% | 0% |
| Overall Treatment Experience | 88% | 10% | 2% | 0% | 0% |
DISCUSSION
The mean pre-treatment overbite measurement in our study was -3.5 mm, indicating a negative overbite characteristic of open bite malocclusions. After Invisalign treatment, the mean overbite improved to + 1.6 mm, which represents a clinically significant change. This result aligns with previous research demonstrating successful overbite correction with Invisalign.[6,7] The positive overbite value post-treatment suggests that patients achieved a more favorable occlusion, which is crucial for both functional and aesthetic outcomes.
The treatment duration in our study averaged 18.2 months, which is consistent with typical Invisalign treatment durations reported in the literature.[5] Patients received an average of 24.7 sets of aligners during their treatment, indicating the need for multiple stages of tooth movement to correct open bites effectively. Additionally, mid-course corrections were performed in 10% of cases, highlighting the flexibility of Invisalign treatment to address evolving treatment needs.
Patient compliance is a critical factor in the success of any orthodontic treatment. In our study, approximately 12% of patients reported compliance issues, such as missed appointments or extended aligner wear times. While this compliance rate is relatively low, it underscores the importance of patient education and motivation throughout the treatment process.
Patient satisfaction with Invisalign treatment was notably high in our study, with approximately 90% of patients reporting very high levels of satisfaction with treatment aesthetics and comfort. These findings are consistent with previous studies that have highlighted the improved aesthetics and reduced discomfort associated with Invisalign compared to traditional fixed appliances.[6] High patient satisfaction is a valuable outcome as it contributes to treatment compliance and overall patient well-being.
CONCLUSION
In conclusion, Invisalign treatment demonstrated effectiveness in correcting open bite malocclusions, as evidenced by significant improvements in overbite measurements and high patient satisfaction rates. While further research with larger sample sizes and longer follow-up periods is needed, our study contributes to the growing body of evidence supporting the use of Invisalign as a viable treatment option for open bite correction.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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