Cone beam computed tomography analysis of anterior open bite management using clear aligners: a single-arm retrospective study

Abstract

Lateral cephalograms have the inherent drawback of superimposition of bilateral structures, while landmarks are more reproducible on CBCT scans. Yet no studies in the literature have utilized 3D imaging to investigate the effects of clear aligners on anterior open bite. Therefore, The aim is to measure the skeletal and dental changes that contribute to anterior open bite closure with clear aligner therapy on CBCT scans. It is a single-arm retrospective study that included 40 cases of anterior open bite who were treated using Invisalign. Pre- and post-treatment CBCT scans were traced to record 13 dental and 3 skeletal measurements. A paired t-test was conducted to compare the mean values of pre- and post-treatment measurements. Combined intrusion of the maxillary right and left molars was statistically significant, meanwhile mandibular molars maintained their vertical position. Maxillary incisors were extruded and retroclined significantly, whereas mandibular incisors were only extruded. While anterior facial height was decreased insignificantly, both lower anterior facial height and mandibular plane angle showed a significant decrease. Clear aligner (Invisalign) therapy is effective in the management of anterior open bite through vertical control, maxillary molars intrusion, maxillary incisors extrusion, maxillary and mandibular incisors retroclination, and mandibular autorotation.