Treatment and posttreatment effects of quad-helix/crib therapy of dentoskeletal open bite

Objective: To investigate the effects of the quad-helix/crib (Q-H/C) appliance in subjects with thumb-sucking habits and dentoskeletal open bite at 2 years after the end of active treatment. Materials and Methods: The records of 21 subjects treated with the Q-H/C appliance were compared with a control group of 21 untreated subjects with similar vertical relationships. Lateral cephalograms were obtained before treatment (T1; mean age 8.4 ± 1.4 years) and at about 2 years after treatment (T2; mean age 11.7 ± 1.9 years) and analyzed. Mean treatment duration was 1.5 years ± 7 months. The T2-T1 changes in the two groups were compared with a non-parametric test for independent samples. Results: The mean increase in overbite during Q-H/C therapy (4.1 mm) represented an overcorrection of the amount of anterior open bite at T2. Both the maxillary and mandibular incisors showed significantly greater extrusion in the Q-H/C group than in the control group. The treated group showed a greater downward rotation (1.8°) of the palatal plane than did the control group. This change was associated with a clinically significant reduction in the palatal plane/mandibular plane angle (-2.5°) in the Q-H/C group. The upper lip showed significant retraction relative to the E-plane in the treated group (3.6 mm) compared with the controls. Conclusions: The Q-H/C appliance was effective in correcting dental open bite in 85% of the growing subjects with thumb-sucking habits and dentoskeletal open bites. Correction of anterior open bite was associated with a clinically significant improvement in maxillomandibular vertical skeletal relationships.