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CompletedNCT04338217Updated Apr 8, 2020

Early Treatment of Skeletal Anterior Open Bite by Two Appliances

An interventional study of Bionator and Removable Appliance with Posterior Bite Planes in Open Bite, sponsored by Damascus University. Completed at 1 site in Syrian Arab Republic. Open to participants aged 7 Years to 10 Years. Per ClinicalTrials.gov, last updated 2020-04-08.

Sponsored by Damascus University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 2 years 7 months after the study started (first participant enrolled Aug 2017, registered Apr 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
7 Years to 10 Years
Sex
All
01

Study summary

Open bite is a common dentoalveolar component of the facial pattern of the excessive vertical dimension patients that is also known as the gaping angle face pattern.It is a deformation in the vertical relationship between the upper and the lower dental arches that is characterized by the loss of contact between the opposite dental segments.

Read the detailed description

An open bite develops as a result of the interaction of many etiologic factors, both hereditary and environmental. Prolonged sucking habits and hyper-divergent facial characteristics are significant risk factors for an anterior open bite in the mixed dentition. Abnormal tongue posture (frequently associated with enlarged adenoids or tonsils) and tongue thrust also can be involved in the establishment of alveolar and skeletal discrepancies concurrent with vertical problems Two types of an open bite are recognized in this profession: (1) dentoalveolar open bite: the abnormality formalities aspects limiting in the dental and alveolar region, usually associated with abnormal function habits as the thumb sucking and (2) Skeletal open bite: that's associated with an over high of the lower facial vertical dimension and a large plane angle of the lower jaw. open bites associated with excessive vertical skeletal dimensions are difficult to treat and tend to relapse The investigators must be recognized between the dentoalveolar open bite and the open bite caused by formalities disorders and the position disorders of the upper or the lower jaw or both. Dental an open bite can be corrected by itself if the treatment was beginning early and it's responding Easley to the mechanical treatment methods and the functional treatment approaches that depending on the muscular activity

02

Conditions studied

  • Open Bite

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03

In context

Open Bite

34 studies on the registry are indexed under Open Bite; 8 are open to participants now.

This study's enrollment of 40 is above the median of 30 across 28 interventional studies indexed under Open Bite.

Browse Open Bite studies →

Lead sponsor

Damascus University is the lead sponsor of 212 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
7 Years to 10 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Anterior open bite (2-10) mm.
  • Skeletal Class I or II malocclusion.
  • MP-SN angle ranged between (33-45) degrees.
  • MM angle ranged between (27-37) degrees.
  • Age between 7.5-10.5 years.

Exclusion criteria

Exclusion Criteria:

  • Patients who had an old orthodontic treatment
  • People with a syndrome or congenital deformity
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Bionator

    The modified Bionator was used to correct the open bite malocclusion. Patients were asked to wear the appliance every day.

    Device: Bionator

  • Active comparator
    Removable Appliance with Posterior Bite Planes

    A removable appliance with poster bite planes was used to correct the open bite malocclusion. Patients were asked to wear this appliance full time expect eating times.

    Device: Removable Appliance with Posterior Bite Planes

Interventions

  • DeviceBionator

    This is a functional appliance that is used to overcome the functional problems and to correct the open bite deformity

  • DeviceRemovable Appliance with Posterior Bite Planes

    This is a one-jaw appliance that is used in conjunction with a tongue crib to control the faulty positions of the tongue and to help in closing the open bite through the use of posterior bite planes.

06

What researchers measure

Primary outcomes

  1. Change in the SNA angle

    This angle represents the position of upper jaw in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between points S, N, and A.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  2. Change in the SNB angle

    This anglrepresents the position of lower jaw in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between points S, N, and B.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  3. Change in the ANB angle

    This angle represents the spatial relationship between the upper and lower jaws in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between A, N, and B.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  4. Changes in the MM angle

    This angle represents the amount of vertical divergence between the upper and lower jaws in the cephalometric analysis. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the maxillary plane and mandibular plane.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  5. Changes in the SN-OCP angle

    This angle represents the relationship between the occlusion plane and the cranial base in the cephalometric analysis in the vertical direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the SN plane (anterior cranial base plane) and the OCP (occlusal) plane.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  6. Changes in the SN-MP angle

    This angle represents the relationship between the lower jaw plane and the cranial base in the cephalometric analysis in the vertical direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the anterior cranial base plane (SN plane) and the mandibular plane (MP plane).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  7. Changes in the SN-SPP angle

    This angle represents the relationship between the upper jaw plane and the cranial base in the cephalometric analysis in the vertical direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the anterior cranial base plane (SN plane) and the maxillary plane (SPP plane).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  8. Changes in the overbite (Ovb)

    This is a vertical measurement done on the cephalometric tracings in millimeters. It is the vertical overlap between the upper incisors and the lower incisors.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  9. Changes in the overjet (Ovj)

    This is a horizontal measurement done on the cephalometric tracings in millimeters. It is the amount of protrusion of upper incisors in relation to the lower incisors.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  10. Changes in the Bjork sum

    Lateral cephalograms will be taken twice and this measurement is the sum of three different angles: (N-S-Ar + S-Ar-Go +Ar-Go-Me). These angles are well-known to orthodontists.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  11. Changes in the N-A-Pog angle

    Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between three points: N, A, and Pogonion (Pog). N is located on the nasal bone. A is located at the maximum concavity of the anterior upper alveolus between the central incisors. Pog is the located at the most prominent point on the chin contour.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  12. Changes in the UI- LI angle

    This angle represents the relationship between the upper and the lower incisor axes in the cephalometric analysis. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the long axis of the upper incisor and the long axis of the lower incisor.

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  13. Changes in the NS-GN angle

    This angle represents the growth pattern of the mandible in the cephalometric analysis in the vertical direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the anterior cranial base plane (NS plane) and the the Y-axis plane (i.e. the facial axis plane defined by two points: Sella Point and Gnathion 'Gn' Point).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  14. Changes in the posterior facial height (S-Go)

    This will be vertically measured in millimeters from S point to Go point. 'S' point referes to Sella Turcica point. 'Go' point refers to the gonial angle point (located at the corner of the mandibular ramus).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  15. Changes in the anterior facial height (N-Me)

    This will be vertically measured in millimeters from N point to Me point. 'N' point refers to the Nasion point. 'Me' point refers to the Menton point (located at the lower border of the chin).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  16. Changes in the 'NasoLab' angle

    This angle represents the relationship between the nose and the upper lip in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between the lower nasal tangent (i.e. the plane that touches the lower border of the columella), and the upper lip plane (i.e. the plane that goes through points Subnasale and Labrale Superius).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

  17. Changes in the 'MentoLab' angle

    This angle represents the relationship between the chin and the lower lip in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken twice and this angle is going to be measured in degrees between two planes: the lower lip tangent plane (from 'Labrale inferius' to mentolabial point) and upper anterior chin plane (from mentolabial point to Pogonion point).

    Time frame: T1: one day before the beginning of treatment; T2: within two hours after the last treatment session

07

Study locations

1 site
  • Orthodontic Department, University of Al-Baath Dental School
    Hama, Hamah 12JO76WH, Syrian Arab Republic
08

References and documents

Publications

  • Torres F, Almeida RR, de Almeida MR, Almeida-Pedrin RR, Pedrin F, Henriques JF. Anterior open bite treated with a palatal crib and high-pull chin cup therapy. A prospective randomized study. Eur J Orthod. 2006 Dec;28(6):610-7. doi: 10.1093/ejo/cjl053. Epub 2006 Nov 13. PubMed 17101701 ↗
  • Defraia E, Marinelli A, Baroni G, Franchi L, Baccetti T. Early orthodontic treatment of skeletal open-bite malocclusion with the open-bite bionator: a cephalometric study. Am J Orthod Dentofacial Orthop. 2007 Nov;132(5):595-8. doi: 10.1016/j.ajodo.2005.12.035. PubMed 18005832 ↗
  • Meibodi SE, Fatahi Meybodi S, Samadi AH. The effect of posterior bite-plane on dentoskeletal changes in skeletal open-bite malocclusion. J Indian Soc Pedod Prev Dent. 2009 Oct-Dec;27(4):202-4. doi: 10.4103/0970-4388.57653. PubMed 19915269 ↗
  • Cozza P, Baccetti T, Franchi L, Mucedero M. Comparison of 2 early treatment protocols for open-bite malocclusions. Am J Orthod Dentofacial Orthop. 2007 Dec;132(6):743-7. doi: 10.1016/j.ajodo.2005.11.045. PubMed 18068591 ↗
  • Mucedero M, Vitale M, Franchi L, Cozza P, Perillo L. Comparisons of two protocols for early treatment of anterior open bite. Eur J Orthod. 2017 Jun 1;39(3):270-276. doi: 10.1093/ejo/cjw039. PubMed 27141934 ↗
  • Cozza P, Baccetti T, Franchi L, McNamara JA Jr. Treatment effects of a modified quad-helix in patients with dentoskeletal open bites. Am J Orthod Dentofacial Orthop. 2006 Jun;129(6):734-9. doi: 10.1016/j.ajodo.2006.02.004. PubMed 16769491 ↗
  • Rossato PH, Fernandes TMF, Urnau FDA, de Castro AC, Conti F, de Almeida RR, Oltramari-Navarro PVP. Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial. Angle Orthod. 2018 Nov;88(6):684-691. doi: 10.2319/101317-691.1. Epub 2018 Jun 18. PubMed 29911909 ↗
  • Giuntini V, Franchi L, Baccetti T, Mucedero M, Cozza P. Dentoskeletal changes associated with fixed and removable appliances with a crib in open-bite patients in the mixed dentition. Am J Orthod Dentofacial Orthop. 2008 Jan;133(1):77-80. doi: 10.1016/j.ajodo.2007.07.012. PubMed 18174075 ↗
  • Mousa MR, Hajeer MY, Farah H. Evaluation of the open-bite Bionator versus the removable posterior bite plane with a tongue crib in the early treatment of skeletal anterior open bite: A randomized controlled trial. J World Fed Orthod. 2021 Dec;10(4):163-171. doi: 10.1016/j.ejwf.2021.08.001. Epub 2021 Aug 27. PubMed 34462242 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Aug 2017 to primary completion in Jun 2018, 10 months.

Of 24 interventional studies with no phase under Open Bite, half reached primary completion within 17 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 36. This study's 10 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 4, 2020
First posted
Apr 8, 2020
StartActual
Aug 15, 2017
Primary completionActual
Jun 20, 2018
CompletionActual
Sep 12, 2018
Last update
Apr 8, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 8, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04338217
Responsible party
Sponsor
First posted
Apr 8, 2020
Start date
Aug 15, 2017
Primary completion
Jun 20, 2018
Completion
Sep 12, 2018
Last update
Apr 8, 2020

Study contacts

Mahran Raheel Mousa, DDS MSc
principal investigator · PhD student, Orthodontics Department, University of Damascus Dental School
Hassan Farah, DDS MSc PhD
study chair · Professor of Orthodontics, University of Hama, Hama, Syria

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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