Dentoalveolar Effects of Miniscrew-Assisted Transpalatal Arch versus Clear Aligner in Anterior Open Bite: A Prospective Cephalometric Study
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Abstract
Background: Treatment of anterior open bite commonly involves anterior extrusion, posterior intrusion, or both. Miniscrew-assisted transpalatal arch (MT) mechanics have been used for maxillary posterior intrusion, whereas clear aligner (CA) therapy has become popular because of its esthetic advantages. However, the mechanics of open-bite correction with clear aligners remain controversial. Objective: To compare dentoalveolar changes following anterior open bite treatment with MT mechanics versus CA therapy using lateral cephalometric analysis. Materials and methods: In this single-center prospective cohort study, 34 adults with anterior open bite (0–4 mm) were treated and evaluated: 15 in the MT group and 19 in the CA group. Lateral cephalograms were obtained at pretreatment (T0) and after 6 months (T1). Within- and between-group dentoalveolar changes were analyzed using paired and independent t-tests (P < 0.05). Results: Both treatments significantly reduced the anterior open bite, with no significant between group difference in overbite change (MT = 3.17 mm, CA = 3.11 mm). MT produced greater maxillary first molar intrusion than CA (U6-PP: MT = 2.01 mm, CA = 0.82 mm). Only the CA group showed a significant increase in anterior dental height (ADH: CA = +1.93 mm). CA showed greater decreases in U1-NA angulation (CA = -5.87°, MT = +2.67°) and U1-NA distance (CA = -1.98 mm, MT = +0.76 mm). Overjet decreased more with CA (P < 0.05). Conclusion: MT with partial fixed anterior archwire primarily produced posterior intrusion and minimal incisor changes, whereas CA predominantly produced maxillary incisor extrusion and retroclination with limited molar intrusion.
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