The short-term skeleto-dental effects of a new spring for the intrusion of maxillary posterior teeth in open bite patients

BACKGROUND: The technology surrounding temporary skeletal anchorage devices has improved in leaps and bounds. However, no specific auxiliary exists for the intrusion of molars in conjunction with these devices and currently clinicians are forced to make do with available force delivery materials. A new intrusion auxiliary, the Sydney Intrusion Spring (SIS), was designed to facilitate intrusion without frequent need for reactivation or tissue irritation. METHODS: The subjects consisted of 16 adolescent patients (12 females and 4 males) with an average age of 13.1 years (range 12.2 to 14.3 years). All patients were in the permanent dentition with an anterior open bite of ≥2 mm. Four self-drilling miniscrews were placed into the posterior maxillary buccal alveolar bone. The intrusion appliance consisted of a bonded acrylic appliance and the SIS, activated to produce an initial intrusive force of 500 g. Cone beam computed tomograms were taken after miniscrew placement and at the end of active intrusion. Rendered lateral cephalograms were produced and measurements were taken and compared. RESULTS: All study objectives were achieved in 4.91 months (range 2.5 to 7.75 months). The mean molar intrusion was 2.9 ± 0.8 mm (P < .001), resulting in over bite increase of 3.0 ± 1.5 mm (P < .001). The intrusion led to a 2.6° ± 1.3° (P < .001) clockwise occlusal plane rotation and a 1.2° ± 1.3° (P < .01) counter-clockwise rotation of the mandible. Dental measurements showed a significant uprighting and elongation of the incisors. There was no significant extrusion of the lower molars. CONCLUSION: The SIS is an effective appliance for the intrusion of maxillary posterior teeth, in conjunction with miniscrews.