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Status unknownNCT05313399Updated Apr 6, 2022

Palatal Crib Versus Bonded Spurs in Early Treatment of Anterior Open Bite Caused by Non-nutritive Sucking Habits: RCT

A Phase 3 interventional study of Palatal Crib and bonded spur in Anterior Open Bite, sponsored by Reem Hatem Shams. Status unknown. Open to participants aged 6 Years to 11 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-04-06.

Sponsored by Reem Hatem Shams · Phase 3, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Apr 2022), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Phase 3
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
6 Years to 11 Years
Sex
All
01

Study summary

The study evaluates the effects of palatal crib versus bonded spurs in the early treatment of anterior open bite caused by non-nutritive sucking habits.

Read the detailed description

Habit is an unintentionally performed repeated activity. Development of habit is considered a part of the natural progression of maturation in children between infancy and three years of age, after this period, it is assumed to be unnatural. The most familiar and earliest noted habit is thumb sucking. It develops during infancy as a rooting reflex, after it ceases around three years of age .

Thumb sucking is defined as the placement of the thumb or one or more fingers in different depths into the mouth ). It emerges in two forms: nutritive and non-nutritive, where the first gives nourishment and the second implements a sense of security and amenity. It is common in children and is reported to be harmless for up to five years of age .

There is an association between the habit of thumb sucking and the development of skeletal open-bite among children. Anterior open bites (AOBs) are defined as an occlusion in which the lower incisors are not overlapped in the vertical plane by the upper incisors and do not occlude with them when the posterior teeth are in maximum intercuspation . Anterior open bite due to thumb sucking, and a secondary tongue thrust exaggerates the condition . If identified early, this can be avoided and appropriate treatment is delivered.

Approaches for habit intervention include counseling, positive reinforcement, a calendar with rewards, an adhesive bandage, bitter nail polish, long sleeves, and appliance therapy. It is recommended to start with the least invasive methods before using habit-breaking appliances. Habit-breaking appliances are either fixed or removable. Fixed appliance therapy may be considered after the age of 4 years. Appliances consisting of cribs in the anterior region are very efficient as reminders and physical restrainers . The palatal crib works as an obstacle in non-nutritive sucking and maintains the tongue in a more retruded position, halting its interposition between the incisors. Spur appliances change tongue action, close the open bite, and boost treatment stability, as it induces a permanent modification of the tongue's anterior rest posture by altering orofacial function, resulting in a change in form. Finally, the spur adjusts the sensory input to the brain. This proprioceptive change leads to an altered motor response, resulting in a new normal tongue rest posture (change in function) that allows the incisors to erupt.

02

Conditions studied

  • Anterior 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 planned enrollment of 30 is close to the median of 30 across 28 interventional studies indexed under Open Bite.

Browse Open Bite studies →

Lead sponsor

This is the only study on the registry with Reem Hatem Shams as lead sponsor.

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

04

Who can participate

Ages eligible
6 Years to 11 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

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

  1. Children with nonnutritive sucking habits and/or tongue thrusting from 6 years to 11 years old.
  2. Angle Class I malocclusions.
  3. Anterior open bite equal to or greater than 1 mm.
  4. Maxillary and mandibular permanent central incisors fully erupted (children in the first transitional period were eligible for treatment when the maxillary lateral incisors were beginning to erupt, and the maxillary central incisors were still showing an open bite).

Exclusion criteria

Exclusion Criteria:

  1. Children with loss of permanent teeth.
  2. Crowding, maxillary constriction, or posterior crossbites.
  3. Previous orthodontic treatment.
  4. Presence of craniofacial anomalies or syndromes.
  5. Tooth agenesis.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
30 participants (estimated)

Study arms

  • Active comparator
    control group

    the group have open bite caused by non-nutritive sucking habits and treat them with palatal crib.

    Device: Palatal Crib

  • Experimental
    experimental group

    the group have open bite caused by by non-nutritive sucking habit and treat them with bonded spur.

    Device: bonded spur

Interventions

  • DevicePalatal Crib

    An intraoral appliance approach can be used as an adjunct method to stop the habit. Appliances consisting of cribs in the anterior region are very efficient as reminders and physical restrainers. The palatal crib works as an obstacle in non-nutritive sucking and maintains the tongue in a more retruded position, halting its interposition between the incisors.

  • Devicebonded spur

    Spur appliances change tongue action, close the open bite, and boost treatment stability, as it induces a permanent modification of the tongue's anterior rest posture by altering orofacial function, resulting in a change in form. Finally, the spur adjusts the sensory input to the brain. This proprioceptive change leads to an altered motor response, resulting in a new normal tongue rest posture (change in function) that allows the incisors to erupt

06

What researchers measure

Primary outcomes

  1. Overbite distance correction in millimeter

    Digital dental model will be scanned using medit software to detect the changes that occur in the vertical distance ( in millimeter ) between incisal edges of the most erupted maxillary and mandibular central incisors in relation to the occlusal plane.

    Time frame: 12 months

Secondary outcomes

  1. Changes in maxillary mandibular plane angle

    standardised lateral cephalometric radiographs will be taken, and the variables will be digitally traced using Dolphin Imaging Software Version 11.5

    Time frame: 12 months

  2. Patient acceptance

    1. The questionnaire is consisted of 5 questions and has space for additional patient comments. 2. The variables in the first four questions will assess speaking, eating, esthetics, and pain. 3. The rating scale that will be used to quantify the effect of the spurs and the palatal crib on these variables 1 (easy), 2 (neutral), and 3 (difficult). 4. The 5th question on the survey will assess the time needed by the patients to adjust the presence of the two appliances. Possible answers are 2 days or less, 1 week, 2 weeks, and longer.

    Time frame: 1 month

07

Study locations

No study locations are listed for this record.

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References and documents

Publications

  • Leite JS, Matiussi LB, Salem AC, Provenzano MG, Ramos AL. Effects of palatal crib and bonded spurs in early treatment of anterior open bite: A prospective randomized clinical study. Angle Orthod. 2016 Sep;86(5):734-9. doi: 10.2319/031815-170.1. Epub 2015 Dec 31. PubMed 26719946 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 6, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05313399
Lead sponsor
Reem Hatem Shams
Responsible party
Reem Hatem Shams (Master Student, Cairo University) — Sponsor-investigator
First posted
Apr 6, 2022
Start date
Apr 1, 2022 (estimated)
Primary completion
Apr 1, 2023 (estimated)
Completion
May 1, 2023 (estimated)
Last update
Apr 6, 2022

Study contacts

Reem H Shams, B.D.S
Contact
reem.shamseldin@dentistry.cu.edu.eg
01099898731 ext. 002
maii M Ali, Lecturer
Contact
maii.ali@dentistry.cu.edu.eg
01012632608 ext. 022
Ahmed H Elkhadem, Ass. professor
study chair · Cairo University

Oversight

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

Not currently enrolling

This study is status unknown, as verified in Apr 2022. You cannot join it, but the record below documents what was studied.

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