Appendix 1: Description of the search strategy,database searches, and results.
Search groups
Key-words
(1)
(a) "open bite"
(b) open-bite
(c) hyperdivergen*
(d) dolichofac*
(2)
management
treatment
therapy
(3)
effective*
correction
change*
relapse
stability
Database
Search strategy
Results(hits)
PubMed (1 AND 2 AND 3)
801
Embase (1 AND 2 AND 3)
520
Cochrane Library
(a)
90
(b)
40
(c)
2
(d)
1
Web of Science (1 AND 2 AND 3)
388
Scopus (1 AND 2 AND 3)
688
Google Scholar† (1 AND 2 AND 3)
100
Scielo (1 AND 2 AND 3)
22
Lilacs (1 AND 2 AND 3)
67
ProQuest Dissertations and Theses Global (1 AND 2 AND 3)
37
ClinicalTrials.gov
(1)
727
European Union Clinical Trials Register
(1)
6
Australian New Zealand Clinical Trials Registry
(1)
2
†On Google Scholar database search, only the first hundred hits were considered.
Appendix 2: CochraneCollaboration’s Tool for Assessing Risk of Bias.
Domain
Sequence generation
YES
Describe the method used to generate the allocation sequence in sufficient
detail to allow an assessment of whether it should produce comparable
groups.
Was the allocation sequence adequately generated?
Allocation concealment
Describe the method used to conceal the allocation sequence in sufficient
detail to determine whether intervention allocations could have been foreseen
in advance of, or during, enrolment.
Was allocation adequately concealed?
Blinding of
assessors.
participants,
personnel
and
outcome
Describe all measures used, if any, to blind study participants and personnel
from knowledge of which intervention a participant received. Provide any
information relating to whether the intended blinding was effective.
Was knowledge of the allocated intervention adequately prevented
during the study?
Incomplete outcome data
Describe the completeness of outcome data for each main outcome, including
attrition and exclusions from the analysis. State whether attrition and
exclusions were reported, the numbers in each intervention group (compared
with total randomized participants), reasons for attrition/exclusions where
reported, and any re-inclusions in analyses performed by the review authors.
Were incomplete outcome data adequately addressed?
Selection outcome reporting
State how the possibility of selective outcome reporting was examined by the
review authors, and what was found.
Are reports of the study free of suggestion of selective outcome
reporting?
Other sources of bias
State any important concerns about bias not addressed in the other domains in
the tool. If particular questions/entries were pre-specified in the review’s
protocol, responses should be provided for each question/entry.
Was the study apparently free of other problems that could put it at a
high risk of bias?
NO
UNCLEAR
Appendix 3: Methodological Index for Non-randomized Trials (MINORS).
Methodological items for non-randomized studies
1_A clearly stated aim
The question addressed should be precise and relevant in the light of available
literature.
2_Inclusion of consecutive patients
All patients potentially fit for inclusion (satisfying the criteria for inclusion) have been
included in the study during the study period (no exclusion or details about the
reasons for exclusion).
3_Prospective collection of data
Data were collected according to a protocol established before the beginning of the
study.
4_Endpoints appropriate to the aim of the study
Unambiguous explanation of the criteria used to evaluate the main outcome which
should be in accordance with the question addressed by the study. Also, the
endpoints should be assessed on an intention-to-treat basis.
5_Unbiased assessment of the study endpoint
Blind evaluation of objective endpoints and double-blind evaluation of subjective
endpoints. Otherwise the reasons for not blinding should be stated.
6_Follow-up period appropriate to the aim of the study
The follow-up should be sufficiently long to allow the assessment of the main
endpoint and possible adverse events.
7_Loss to follow up less than 5%
All patients should be included in the follow up. Otherwise, the proportion lost to
follow up should not exceed the proportion experiencing the major endpoint.
8_Prospective calculation of the study size
Information of the size of detectable difference of interest with a calculation of 95%
confidence interval, according to the expected incidence of the outcome event, and
information about the level for statistical significance and estimates of power when
comparing the outcomes.
Additional criteria in the case of comparative study
9_An adequate control group
Having a gold standard diagnostic test or therapeutic intervention recognized as the
optimal intervention according to the available published data.
Score
10_Contemporary groups
Control and studied group should be managed during the same time period (no
historical comparison).
11_Baseline equivalence of groups
The groups should be similar regarding the criteria other than the studied endpoints.
Absence of confounding factors that could bias the interpretation of the results.
12_Adequate statistical analyses
Whether the statistics were in accordance with the type of study with calculation of
confidence intervals or relative risk.
TOTAL
The items are scored 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate)
Appendix4: Articles excluded after full-text evaluation and reasons for exclusion.
Reference
Dermaut, L.R., van den Eynde, F., de Pauw, G. (1992) Skeletal and dento-alveolar changes as a result of headgear
activator therapy related to different vertical growth patterns. European Journal of Orthodontics, 14,140-146.
Basciftci, F.A., Karaman, A.I. (2002) Effects of a modified acrylic bonded rapid maxillary expansion appliance and vertical
chin cap on dentofacial structures. Angle Orthodontist, 72, 61-71.
Buschang, P.H., Sankey, W., English, J.D. (2002) Early treatment of hyperdivergent open-bite malocclusions. Seminars in
Orthodontics, 8, 130-140.
Cousley, R.R.(2014) Molar intrusion in the management of anterior openbite and ‘high angle’ Class II malocclusions.
Journal of Orthodontics, 41, ps39-s46.
Sun, X., Zhao, Z.(2014) Treatment of open bite and closing of relapsed space.American Journal of Orthodontics and
Dentofacial Orthopedics,145, 714.
Bosio, J.A., Justus, R.(2014) Treatment of open bite and closing of relapsed space.Authors' response.American Journal of
Orthodontics and Dentofacial Orthopedics, 145, 715.
Parks, L.R., Buschang, P.H., Alexander, R.A., Dechow, P., Rossouw, P.E. (2007) Masticatory exercise as an adjunctive
treatment for hyperdivergent patients. Angle Orthodontist,77, 457-462.
Buschang, P.H., Jacob, H.B., Chaffee, M.P. (2012) Vertical control in Class II hyperdivergent growing patients using
miniscrew implants: A pilot study. Journal of the World Federation of Orthodontists, 1, 13-18.
Fuentevilla, R.C. Orthopedic Correction of Growing Retrognathic Hyperdivergent Patients [doctor’s thesis]. [College Station,
TX]: Texas A&M University; 2014. 165p.
Meral, O., Yüksel, S. (2003) Skeletal and dental effects during observation and treatment with a magnetic device. Angle
Orthodontist,73, 716-722.
Meyer-Marcotty, P., Hartmann, J., Stellzig-Eisenhauer, A. (2007) Dentoalveolar open bite treatment with spur appliances.
Journal of Orofacial Orthopedics, 68, 510-521.
Meibodi, S.E., FatahiMeybodi, S., Samadi, A.H. (2009) The effect of posterior bite-plane on dentoskeletal changes in
skeletal open-bite malocclusion. Journal of the Indian Society ofPedodontics and Preventive Dentistry, 27, 202-204.
Lu, J., Gong, F.F., Shen, G. (2010) Therapeutical effect of rapid maxillary expansion in treating open bite due to thumbsucking. Fudan University Journal of Medical Sciences, 37, 414-417.
Buschang, P.H., Carrillo, R., Rossouw, P.E. (2011) Orthopedic correction of growing hyperdivergent, retrognathic patients
with miniscrew implants. Journal of Oral and Maxillofacial Surgery, 69, 754-762.
Mazzali M., Garbui, I.U., Nouer, D.F., Nouer, P.R.A. (2011) Controle vertical no tratamento da maloclusão classe II, divisão
1 de Angle associada à mordida aberta com aparelho extrabucal conjugado. RGO Revista Gaúcha de Odontologia, 59,1521.
Reason for exclusion
Not an investigation aimed at
evaluating AOB or HSP treatment
Not an investigation aimed at
evaluating AOB or HSP treatment
Literature review
Literature review
Letter
Letter
Orthodontic treatment involving
bracketsappliances
Orthodontic treatment involving
brackets appliances
Orthodontic treatment involving
brackets appliances
Case series
Case series
Case series
Case series
Case series
Case series
Meyer-Marcotty, P., Kochel,J., Stellzig-Eisenhauer, A. (2013) The impact of spur therapy in dentoalveolar open bite.
Australian orthodontic journal, 29, 145-152.
Hart, T.R., Cousley, R.R., Fishman, L.S., Tallents, R.H. (2014) Dentoskeletal changes following mini-implant molar intrusion
in anterior open bite patients. Angle Orthodontist,(in press).
Foot, R., Dalci, O., Gonzales, C., Tarraf, N.E., Darendeliler, M.A. (2014) The short-term skeleto-dental effects of a new
spring for the intrusion of maxillary posterior teeth in open bite patients. Prog in Orthodontics, 15, 56.
Celli, D., de Carlo, A., Gasperoni, E., Deli, R. (2014) A 3-year evaluation of anterior open bite treatment stability with
occlusal adjustment. Global Journal of Medical Research: Journal of Dentistry and Otolaryngology, 14, 15-22.
Erverdi, N., Kucukkeles, N., Arun, T., Biren, S. (1992) Cephalometric evaluation of crib therapy for cases of mixed dentition
(open bite). The Journal of Nihon University School of Dentistry, 34, 131-136.
Junkin, J.B., Andria, L.M.(2002) Comparative long term post-treatment changes in hyperdivergent Class II Division 1
patients with early cervical traction treatment. Angle Orthodontist, 72, 5-14.
Huang, G.J., Justus, R., Kennedy, D.B., Kokich, V.G. (1990) Stability of anterior openbite treated with crib therapy. Angle
Orthodontist, 60, 17-24.
Scheffler, N.R., Proffit, W.R., Phillips, C. (2014) Outcomes and stability in patients with anterior open bite and long anterior
face height treated with temporary anchorage devices and a maxillary intrusion splint. American Journal of Orthodontics and
Dentofacial Orthopedics, 146,594-602.
Ferreira, F.P.C. Estabilidade do tratamento precoce da mordida aberta anterior, utilizando aparelho removível com grade
palatina, associado à mentoneira [doctor’sthesis]. [Bauru, Brazil]:Faculdade de Odontologia de Bauru; 2008. 247 p.
Ferreira, F.P.C., Almeida, R.R., Torres, F.C., Almeida-Pedrin, R.R., Almeida, M.R., Santana Filho, R. (2012) Evaluation of
the stability of open bite treatment using a removable appliance with palatal crib combined with high-pull chincup. Dental
Press Journal of Orthodontics, 17, 52-60.
Foot, R. Australian and New Zealand Clinical Trials Registry [Internet]: Sydney: The effects of the Sydney Intrusion Spring
(SIS) on the maxillary posterior dental segments with the application of an intrusive force; 2010 [cited 2015 March 7].
Available from https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=335105
Kuster, R.,Ingervall, B. Treatment of skeletal open bite with two types of bite-blocks [abstract]. (1992) European journal of
Orthodontics, 14, 326.
Pedrin, F., Almeida, M.R., Almeida, R.R., Almeida-Pedrin, R.R., Torres, F. (2006) A prospective study of the treatment
effects of a removable appliance with palatal crib combined with high-pull chincup therapy in anterior open-bite patients.
American Journal of Orthodontics and Dentofacial Orthopedics, 129, 418-423.
Torres, F., Almeida, R.R., Almeida, M.R., Almeida-Pedrin, R.R., Pedrin, F., Henriques, J.F. (2006) Anterior open bite treated
with a palatal crib and high-pull chin cup therapy. A prospective randomized study. European Journal of Orthodontics,28,
610-617.
Cassis, M.A., Almeida, R.R., Janson, G., Almeida-Pedrin, R.R., Almeida, M.R. (2012) Treatment effects of bonded spurs
associated with high-pull chincup therapy in the treatment of patients with anterior open bite. American Journal of
Orthodontics and Dentofacial Orthopedics, 142, 487-493.
Case series
Case series
Case series
Case series
Non-matched control group
Non-matched control group
One sub-group with mean age
over 18 years
Sample with mean age over 18
years
No baseline data
No baseline data
No data available
Duplicate results
Duplicate results
Duplicate results
Duplicate results
Torres, F.C., Almeida, R.R., Almeida-Pedrin, R.R., Pedrin, F., Paranhos, L.R. (2012) Dentoalveolar comparative study
between removable and fixed cribs, associated to chincup, in anterior open bite treatment. Journal of Applied Oral Sciences,
20, 531-537.
Schellinck, M. Dental and skeletal changes in growing class II hyperdivergent patients treated with a mini-screw intrusion
appliance. [master’s thesis]. [College Station, TX]: Texas A&M University; 2013. 58p.
Ciavarella, D., Lo Russo, L., Mastrovincenzo, M., Padalino, S., Montaruli, G., Giannatempo, G., Cassano, M., Laino, L., Lo
Muzio, L. (2014) Cephalometric evaluation of tongue position and airway remodelling in children treated with swallowing
occlusal contact intercept appliance (S.O.C.I.A.). International Journal of Pediatric Otorhinolaryngology, 78, 1857-1860.
Duplicate results
Duplicate results
No outcome of interest
Appendix5: Inclusion criteria used during sample recruitment in the selected studies.
Studies
Hyperdivergent
skeletal pattern
Fränkel and Fränkel (30)
X
Erbay et al. (38)
X
X
Haydar and Enacar (33)
X
X
Defraia et al. (14)
X
Cozza et al.(12)
X
Freeman et al. (15)
X
Anterior open-bite
Skeletal Class I
Skeletal Class II
Class I
malocclusion
Class II
malocclusion
Use of the
appliance
X
X
X
X
Weinbach and Smith (37)
Işcan and Sarisoy (40)
X
X
Kiliaridis et al. (31)
X
X
Işcan et al.(34)
X
X
Barbre and Sinclair (32)
X
X
X
X
X
X
X
X
X
X
X
Bazzucchi et al. (41)
Doshi and Bhad-Patil (21)
X
X
X
X
Kuster and Ingervall (35)
X
X
X
X
Albogha et al. (25)
X
X
Sankey et al. (42)
X
Baccetti et al. (16)
X
Schulz et al. (45)
X
X
X
Çinsar et al. (11)
X
X
Ngan et al. (36)
X
X
X
Jacob et al. (24)
X
X
X
X
Işcan et al.(43)
X
X
X
X
X
X