Assessment Of Class 3 Management With Orthodontic Tongue Crib Appliance: Prospective Cephalometric Study

Abstract

Objectives The aim of the study was assessment the orthodontic tongue crib efficiency for treating skeletal class 3 and open bite malocclusion in growing children by cephalometric measurements analysis. Materials and Methods The sample comprised of 18 growing children with class 3 of deficient maxilla and anterior open bite malocclusion. The patients (boys 5 and girls 13 with mean age 8.89° ± 1.6 years) were treated with fixed tongue crib and tongue exercise therapy. Lateral cephalograms were arranged and analyzed before treatment and after 12 months for comparing the skeletal changes of the craniofacial structures. Results After 12 months of treatment with the tongue crib appliance, all patients got a favorable facial profile and lip closure improved, and positive overjet was achieved. Anterior crossbite as well as open bite, and upper and lower first molars relationships were improved. In cephalometric measurements analysis revealed that significant forward growth of the maxilla exhibited in a statistical increase of SNA, maxillary depth p<0.001(SNA angle had increased from 78.75° to 81.12° and ANB angle had changed from 0.3° to +2.25°). The mandible revealed slightly significant increase in facial angle from 83.75° to 84.94° and non- significant change of SNB. Regarding vertical changes, growth was shown significant as increase in FMA, SN-PP, and ANS-Me. ConclusionsTongue crib appliance is an effective device for the patients in the growing period with skeletal Class 3 and open bite malocclusions, by improving the maxillary complex growth. Orthodontic Tongue crib appliance might be an alternative method to facemask extra-oral appliances.