Molar intrusion in open bite: effects on vertical dimension and temporomandibular joint
Keywords:
MORDIDA ABIERTA; TÉCNICAS DE MOVIMIENTO DENTAL; TRASTORNOS DE LA ARTICULACIÓN TEMPOROMANDIBULAR.; OPEN BITE; TOOTH MOVEMENT TECHNIQUES; TEMPOROMANDIBULAR JOINT DISORDERS.; MORDIDA ABERTA; TÉCNICAS DE MOVIMENTAÇÃO DENTÁRIA; TRANSTORNOS DA ARTICULAÇÃO TEMPOROMANDIBULAR.Abstract
Introduction: molar intrusion, used to correct anterior open bites, reduces vertical dimension and causes mandibular rotation, but it may alter condylar position and affect the temporomandibular joint.
Objective: to analyze the effects of molar intrusion on the temporomandibular joint and vertical dimension, evaluating joint alterations and skeletal stability after treatment.
Methods: a systematic review of the scientific literature was conducted in different databases, using a search algorithm to identify relevant sources. The selected studies, after applying rigorous inclusion and exclusion criteria, were critically appraised in terms of currency, methodological quality, and thematic relevance, and coherently integrated into the final synthesis of the review. Development: molar intrusion decreases vertical dimension, with a greater effect in growing patients and those with skeletal anchorage. In the temporomandibular joint, no worsening of previous dysfunctions was observed; in healthy or stabilized joints, clinical improvements were even described. The stability of the vertical correction and mandibular rotation is maintained in medium-term follow-up with minimal relapse. However, variability in diagnostic methods and the short duration of the studies limit the generalizability of these findings.
Conclusions: molar intrusion offers aesthetic and functional benefits, reducing the vertical dimension and promoting mandibular rotation without apparent adverse effects on the temporomandibular joint. Long-term studies and standardized diagnostic methodologies are required to fully confirm these current findings.
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1. Benedi García MM, Díaz Castro A. Mordida Abierta Anterior: Definición, Manifestaciones Clínicas, Clasificación, Etiología y Terapéuticas (Revisión bibliográfica). Rev Latinoam Ortodoncia Odontopediatr[Internet]. 2021[citado 14/07/2025]; 2021(1): Disponible en: https://www.ortodoncia.ws/publicaciones/2021/art-5/
2. Carulla Martínez D, Curbelo Mesa R, Benedit García MM. Mordida Abierta Anterior: Denticiones, Categorías y Terapéuticas – Revisión bibliográfica. Rev Latinoam Ortodoncia Odontopediatr[Internet]. 2020[citado 14/07/2025]; 20(1): 123–130. Disponible en: https://www.ortodoncia.ws/publicaciones/2020/art-7/
3. Hsu JY, Cheng JH, Feng SW, Lai PC, Yoshida N, Chiang PC. Strategic treatment planning for anterior open bite: A comprehensive approach. J Dent Sci[Internet]. 2024 Jul[citado 14/07/2025]; 19(3): 1328-1337. Disponible en: https://doi.org/10.1016/j.jds.2024.04.001
4. Salame Ortiz VA, Amancha Salguero KB, Almendariz Ormaza DN, Quiroz Molina JJ. Tratamiento de la mordida abierta anterior por hábitos y su estabilidad a largo plazo. Rev Inf Cient [Internet]. 2024 [citado 14/07/2025]; 103(1Sup): e4525. Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/4525
5. Nieto-Pillco M, Lima-Illescas M. Tratamiento ortodóntico de la mordida abierta anterior en adolescentes y adultos: revisión de literatura. 593 Digital Publisher CEIT[Internet]. 2023 May[citado 14/07/2025]; 8(3): 528–43. Disponible en: https://doi.org/10.33386/593dp.2023.3.1780
6. Hasan AA, Zeidan HM, Hajeer MY, Al-Jundi A, Al-Sabbagh R, Khattab TZ, Al-Munajed MK. Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial. Cureus[Internet]. 2022 Dec[citado 14/07/2025]; 14(12): e32826. Disponible en: https://doi.org/10.7759/cureus.32826
7. Hsu LF, Liu YJ, Wang SH, Chen YJ, Chen YJ, Yao CJ. Orthodontic correction of acquired open bite with TMJ degeneration: A retrospective study of outcomes and stability. J Formos Med Assoc[Internet]. 2024 Apr[citado 14/07/2025]; 123(4): 452-460. Disponible en: https://doi.org/10.1016/j.jfma.2023.10.006
8. Oliveira TF, Nakao CY, Gonçalves JR, Santos-Pinto A. Maxillary molar intrusion with zygomatic anchorage in open bite treatment: lateral and oblique cephalometric evaluation. Oral Maxillofac Surg[Internet]. 2015 Mar[citado 14/07/2025]; 19(1): 71-77. Disponible en: https://doi.org/10.1007/s10006-014-0457-2
9. Elshal MG. Dentoskeletal changes of anterior openbite cases treated by intrusion of maxillary posterior segments via zygomatic miniplates. Med Sci[Internet]. 2021 Feb[citado 14/07/2025]; 25(108): A1. Disponible en: https://mail.discoveryjournals.org/medicalscience/current_issue/v25/n108/A1.htm
10. Kang DO, Yu HS, Choi SH, Kim ST, Jung HD, Lee KJ. Stability of vertical dimension following total arch intrusion. BMC Oral Health[Internet]. 2023 Mar 22[citado 14/07/2025]; 23(1):164. Disponible en: https://doi.org/10.1186/s12903-023-02842-1
11. Kassem HE, Marzouk ES. Prediction of changes due to mandibular autorotation following miniplate-anchored intrusion of maxillary posterior teeth in open bite cases. Prog Orthod[Internet]. 2018 May 14[citado 14/07/2025]; 19(1):13. Disponible en: https://doi.org/10.1186/s40510-018-0213-5
12. Kim K, Choy K, Park YC, Han SY, Jung H, Choi YJ. Prediction of mandibular movement and its center of rotation for nonsurgical correction of anterior open bite via maxillary molar intrusion. Angle Orthod[Internet]. 2018 Sep[citado 14/07/2025]; 88(5): 538-544. Disponible en: https://doi.org/10.2319/102317-714.1
13. Marzouk ES, Abdallah EM, El-Kenany WA. Molar Intrusion in Open-bite Adults Using Zygomatic Miniplates. Int J Orthod Milwaukee[Internet]. 2015 Summer[citado 14/07/2025]; 26(2): 47-54. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26349291/
14. Marzouk ES, Kassem HE. Long-term stability of soft tissue changes in anterior open bite adults treated with zygomatic miniplate-anchored maxillary posterior intrusion. Angle Orthod[Internet]. 2018 Mar[citado 14/07/2025]; 88(2): 163-170. Disponible en: https://doi.org/10.2319/072317-490.1
15. Nemes B, Frank D, Puigdollers A, Martín D. Occlusal Splint Therapy Followed by Orthodontic Molar Intrusion as an Effective Treatment Method to Treat Patients with Temporomandibular Disorder: A Retrospective Study. Appl Sci[Internet]. 2021[citado 14/07/2025]; 11(16): 7249. Disponible en: https://doi.org/10.3390/app11167249
16. Ogura H, Numazaki K, Oyanagi T, Seiryu M, Ito A, Noguchi T, Ohori F, Yoshida M, Fukunaga T, Kitaura H, Mizoguchi I. Three-Dimensional Evaluation of Treatment Effects and Post-Treatment Stability of Maxillary Molar Intrusion Using Temporary Anchorage Devices in Open Bite Malocclusion. J Clin Med[Internet]. 2024 May[citado 14/07/2025]; 13(10): 2753. Disponible en: https://doi.org/10.3390/jcm13102753
17. Scheffler NR, Proffit WR, Phillips C. Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint. Am J Orthod Dentofacial Orthop[Internet]. 2014 Nov[citado 14/07/2025];146(5): 594-602. Disponible en: https://doi.org/10.1016/j.ajodo.2014.07.020
18. Turkkahraman H, Sarioglu M. Are temporary anchorage devices truly effective in the treatment of skeletal open bites? Eur J Dent[Internet]. 2016 Oct-Dec[citado 14/07/2025]; 10(4): 447-453. Disponible en: https://doi.org/10.4103/1305-7456.195169
19. Vela-Hernández A, López-García R, García-Sanz V, Paredes-Gallardo V, Lasagabaster-Latorre F. Nonsurgical treatment of skeletal anterior open bite in adult patients: Posterior build-ups. Angle Orthod[Internet]. 2017 Jan[citado 14/07/2025]; 87(1): 33-40. Disponible en: https://doi.org/10.2319/030316-188.1
20. Chen YJ, Chen HH, Hsu LF, Wang SH, Chen YJ, Lai EH, Chang JZ, Yao CJ. Airway increase after open bite closure with temporary anchorage devices for intrusion of the upper posteriors: Evidence from 2D cephalometric measurements and 3D magnetic resonance imaging. J Oral Rehabil[Internet]. 2018 Dec[citado 14/07/2025]; 45(12): 939-947. Disponible en: https://doi.org/10.1111/joor.12712
21. Abdulnabi Y, Albogha MH, Abuhamed H, Kaddah A. Non-surgical treatment of anterior open bite using miniscrew implants with posterior bite plate. Orthod Waves[Internet]. 2017[citado 14/07/2025]; 76(1): 40–45. Disponible en: https://doi.org/10.1016/j.odw.2016.11.006
22. Akan B, Ünal BK, Şahan AO, Kızıltekin R. Evaluation of anterior open bite correction in patients treated with maxillary posterior segment intrusion using zygomatic anchorage. Am J Orthod Dentofacial Orthop[Internet]. 2020 Oct[citado 14/07/2025]; 158(4): 547-554. Disponible en: https://doi.org/10.1016/j.ajodo.2019.09.018
23. Akbaydogan LC, Akin M. Cephalometric evaluation of intrusion of maxillary posterior teeth by miniscrews in the treatment of open bite. Am J Orthod Dentofacial Orthop[Internet]. 2022 May[citado 14/07/2025]; 161(5): 621-627. Disponible en: https://doi.org/10.1016/j.ajodo.2020.11.033
24. Hart TR, Cousley RR, Fishman LS, Tallents RH. Dentoskeletal changes following mini-implant molar intrusion in anterior open bite patients. Angle Orthod[Internet]. 2015 Nov[citado 14/07/2025]; 85(6): 941-8. Disponible en: https://doi.org/10.2319/090514-625.1
25. Acar YB, Özbilen EÖ, Yıldırım G, Kahraman D, Tozlu M, Erverdi AN. Dentoalveolar and Skeletal Effects of an Anterior Open Bite Treatment Protocol Using Zygomatic Anchorage. Orthod Craniofac Res[Internet]. 2025 Jun[citado 14/07/2025]; 28(3): 507-514. Disponible en: https://doi.org/10.1111/ocr.12901
26. Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St. Louis: Elsevier[Internet]; 2012 april[citado 14/07/2025]. Disponible en: https://shop.elsevier.com/books/management-of-temporomandibular-disorders-and-occlusion/okeson/978-0-323-08220-4
27. Cevidanes LH, Hajati AK, Paniagua B, Lim PF, Walker DG, Palconet G, Nackley AG, Styner M, Ludlow JB, Zhu H, Phillips C. Quantification of condylar resorption in temporomandibular joint osteoarthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod[Internet]. 2010 Jul[citado 14/07/2025]; 110(1): 110-7. Disponible en: https://doi.org/10.1016/j.tripleo.2010.01.008
28. González Espinosa D, de Oliveira Moreira PE, da Sousa AS, Flores-Mir C, Normando D. Stability of anterior open bite treatment with molar intrusion using skeletal anchorage: a systematic review and meta-analysis. Prog Orthod[Internet]. 2020 Sep[citado 14/07/2025]; 21(1): 35. Disponible en: https://doi.org/10.1186/s40510-020-00328-2
29. De Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. 6th ed. Chicago: Quintessence Publishing; 2018.
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Copyright (c) 2026 Elizabeth Estrella Paucar Toribio, Rocío del Pilar Sandoval Gálvez, Lucas Bastian Quiroz Matamoros, Montserrat Casals Soderlund
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