Clinical complications during early treatment of anterior open bite

Abstract The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn’s post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.摘要 本研究旨在对比4种用于前牙开颌（anterior open bite, AOB）早期矫治的不同矫治器的临床并发症情况，并检验“不同矫治器的并发症数量无差异”的零假设。本研究纳入99例伴前牙开颌的安氏I类错颌畸形患者，分别采用粘结式尖牙导板（bonded spurs, BS，n=25）、颏兜（chin cup, CC，n=25）、固定式腭屏（fixed palatal crib, FPC，n=25）及可摘式腭屏（removable palatal crib, RPC，n=24）进行矫治，对其诊疗记录进行回顾分析。采用卡方检验及Kruskal-Wallis检验（Dunn事后检验）对12个月内发生的临床并发症总数及发生频率进行描述与比较，检验水准设为α=5%，置信区间（confidence interval, CI）为95%。本研究中临床并发症总发生率为66.7%，并发症类型包括矫治器破损、粘结失败、适配不良、过敏反应、软组织损伤、可摘矫治器丢失及治疗放弃。共有18例患者放弃治疗，该情况在可摘矫治器组中更为常见。就每位患者的并发症总数而言，BS组的并发症数量显著高于其余各组（p=0.094）。由于BS组的并发症总数及发生频率均为最高，因此本研究拒绝零假设。尽管可摘矫治器组的放弃治疗患者更多，但固定式与可摘式矫治器的临床并发症发生率并无显著差异。