Conventional Palatal Crib Versus Bonded Spurs for Anterior Open Bite Treatment

NCT07509567 | Not Yet Recruiting

• 1 other identifier: MS.26.01.112
• Study Type: interventional
• Target: 20
• Locations: 0 countries
• Sites: N/A

Brief Summary

This randomized clinical trial aims to compare the effectiveness and patient acceptance of two orthodontic appliances-conventional palatal crib and bonded spurs-in the treatment of anterior open bite in children.Twenty children aged 7 to 12 years with anterior open bite and Class I skeletal and dental relationships will be randomly assigned to one of two groups The first group will receive a conventional palatal crib appliance fixed to the upper molars, while the second group will receive bonded spurs attached to the palatal surfaces of the upper incisors , All participants will be followed for 6 months. Clinical and digital measurements, including overbite ,The results of this study are expected to help determine which appliance provides better clinical outcomes and higher patient acceptance in the early treatment of anterior open bite.

Conditions

Anterior Open Bite

Keywords

Anterior Open Bite , Palatal Crib , Bonded Spurs

Outcome Measures

Primary Outcomes (1)

• Change in Anterior Open Bite (AOB)

  Measurement of vertical overlap (in mm) between the upper and lower anterior teeth before and after treatment using intraoral scans.

  6 months

Secondary Outcomes (1)

• Overbite and Overjet Changes

  6 months

Study Arms (2)

Conventional Palatal Crib (CPC)

EXPERIMENTAL

Participants will receive a conventional palatal crib appliance fixed to the maxillary first molars. The appliance is made of 0.9 mm stainless steel wire with 5-7 loops and an acrylic button covering the base. It is positioned 3-4 mm posterior to the cingula of the maxillary incisors to prevent tongue thrusting. The appliance is cemented with glass ionomer cement and monitored over a 6-month treatment period.

Device: Conventional Palatal Crib

Bonded Spurs (BS)

EXPERIMENTAL

Participants will receive bonded spurs attached to the middle third of the palatal surfaces of the maxillary and mandibular incisors to correct anterior tongue posture and prevent contact with anterior teeth. The spurs act as a reminder to maintain proper tongue positioning. Treatment is monitored over a 6-month period.

Device: Bonded Spurs

Interventions

Conventional Palatal Crib DEVICE

A fixed orthodontic appliance made of 0.9 mm stainless steel wire with 5-7 loops and an acrylic button covering the base.It is cemented to the maxillary first molars using Ultra band cement and positioned 3-4 mm posterior to the cingula of maxillary incisors to prevent tongue thrusting. Treatment duration is 6 months.

Conventional Palatal Crib (CPC)

Bonded Spurs DEVICE

Bonded spurs are placed on the middle third of the palatal surfaces of the maxillary and mandibular incisors. They correct anterior open bite by preventing the tongue from contacting the upper and lower anterior teeth and reminding the patient to maintain proper tongue position. Treatment duration is 6 months.

Bonded Spurs (BS)

Eligibility Criteria

• Age: 7 Years - 12 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children aged 7 to 12 years
• Skeletal Class I relationship
• Angle Class I dental relationship
• Dental anterior open bite ≥ 1 mm
• Open bite limited to the anterior segment (incisors and canines)
• Presence of tongue thrusting habit with anterior tongue posture
• Patients in mixed dentition stage
• Fully erupted upper and lower central incisors
• Fully erupted maxillary first permanent molars
• Good oral hygiene
• No gender restrictions
• Upper arch with no or mild crowding

You may not qualify if:

• Mouth breathing
• Skeletal anterior open bite
• Presence of posterior crossbite
• Congenitally missing teeth
• Dental anomalies
• Presence of any systemic disease

Sponsors & Collaborators

• Mansoura University: lead

Related Publications (10)

• 10. Duarte-Rodrigues L, Ramos-Jorge J, Drumond CL, Diniz PB, Marques LS, Ramos-Jorge ML. Correlation and comparative analysis of the CPQ8-10 and child-OIDP indexes for dental caries and malocclusion. Brazilian Oral Research. 2017;31(0).

  RESULT

• 9. Nasser M, Yousry TN, Ismail H. Patient Acceptance and Satisfaction: A Comparative Study of Low Transpalatal Arch with Tongue Spurs versus Tongue Spurs Alone in Developing Anterior Open Bite Treatment. Egyptian Orthodontic Journal. 2025;67(1):157-77.

  RESULT

• 8. Zhao W, Chen Y, Kyung H-M, Xu J-S. Effectiveness of Tongue Crib Combination Treating Severe Skeletal Angle Class III Malocclusion in Mixed Dentition. International Journal of Clinical Pediatric Dentistry. 2020;13(6):668-76.

  RESULT

• 7. Rossato PH, Fernandes TMF, Urnau FDA, de Castro AC, Conti F, de Almeida RR, Oltramari-Navarro PVP. Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial. The Angle Orthodontist. 2018;88(6):684-91.

  RESULT

• 6. Kraisiridej R, Suzuki B, Suzuki EY. Dentoalveolar changes observed after the use of customized bonded Shark-Tooth-Like Spurs (JAWs) in adult patients with anterior open bite. Dental Press Journal of Orthodontics. 2022;27(5).

  RESULT

• 5. Alawy SB, El-Desouky SS, Kabbash IA, Hadwa SM. Effects of tongue tamers and customized bonded spurs as an early treatment of anterior open bite: a randomized clinical study. BMC Oral Health. 2025;25(1).

  RESULT

• 4. Stuani AS, Stuani AS, Stuani MBS, Saraiva MdCP, Matsumoto MAN. Anterior open bite: cephalometric evaluation of the dental pattern. Brazilian Dental Journal. 2006;17(1):68-70.

  RESULT

• 3. Manzoor Z, Wadhawan A, Nagar S, Kumar A, Singh M. A Modified Tongue Crib Appliance for Correction of Tongue Thrusting. Cureus. 2023.

  RESULT

• 1. Fouda AS, Afify AK, Aboulfotouh MH, Attia KH, Abouelezz AM, Elkordy SA. Dental arch changes after anterior open bite treatment in the mixed dentition produced by miniscrew-supported palatal crib vs conventional fixed palatal crib. The Angle Orthodontist. 2022;92(4):487-96.

  RESULT

• Dias FA, Assis Urnau FD, Pedron Oltramari PV, Lupion Poleti M, Rodrigues de Almeida M, Freire Fernandes TM. Stability of early treatment of anterior open bite: clinical performance of bonded lingual spurs. Journal of Orthodontics. 2019;46(1):68-73.

  RESULT

Related Links

• Official website of Mansoura University

Study Officials

• Dr. Ahmed El-Bialy, Professor, Department of Ortho

  Faculty of Dentistry, Mansoura University

  STUDY CHAIR

Central Study Contacts

Hassan Hani Al-fadhli, B.D.Sc

CONTACT

021555422609; Hassan_Alfadhli@std.mans.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Blinding of participants and care providers is not feasible due to the nature of the interventions. However, outcome assessors and data analysts will be blinded to group allocation to reduce measurement bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Postgraduate Student, Department of Orthodontics, Faculty of Dentistry

Model Details: Participants will be randomly assigned into two parallel groups with a 1:1 allocation ratio. One group will receive a conventional palatal crib appliance, while the other group will receive bonded spurs. Both interventions will be applied simultaneously, and outcomes will be compared after a 6-month follow-up period.

Study Record Dates

• First Submitted: March 29, 2026
• First Posted: April 3, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: April 8, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share