Effect of bonded lingual spurs with low trans palatal arch on developing anterior open bite (a randomized controlled trial)

Anterior Open Bite (AOB) is a complex malocclusion with esthetic, functional, and psychosocial implications, highlighting the need for early diagnosis and interceptive treatment. To compare the effectiveness of bonded Tongue Spurs combined with a Low Trans Palatal Arch (TS/LTPA) versus bonded Tongue Spurs (TS) alone in managing AOB associated with tongue habit during the mixed dentition stage. Fifty children were assessed for eligibility; 32 were randomized, and 30 completed the 6-month follow-up and were included in the final analysis. They aged 7 to 11 years (10 boys, 20 girls) in the mixed dentition phase, having a dentoskeletal AOB of at least 1 mm, an Angle Class I molar relationship, and CMI stages 2 and 3. TS/LTPA group comprised 16 patients (7 males and 9 females) exhibiting bonded lingual tongue spurs and a low transpalatal arch. TS group included 14 patients (3 males and 11 females) who had bondable lingual tongue spurs only. The mean age was 8.73 ± 1.00 years in the TS/LTPA group and 9.03 ± 0.68 years in the TS group. Digital lateral cephalograms and models were obtained prior to and six months post-treatment. Both groups (TS/LTPA and TS) showed improvement in overbite closure, with a median change of + 2.97 mm (IQR 1.16 to 5.00; p < .001) in the TS/LTPA group and + 3.67 mm (IQR 2.00 to 5.00; p = .001) in the TS group, respectively. However, the difference between groups was not statistically significant. A statistically significant vertical molar control was observed in the TS/LTPA group (+ 0.40 mm, IQR 0.30 to 0.65; p = .001) compared to the TS group (+ 0.90 mm, IQR 0.70 to 1.00; p = .001), with significant differences between both groups. Both TS/LTPA and TS groups showed a reduction in overbite, along with incisor extrusion and retroclination. The TS/LTPA group provided significantly better vertical molar control than the TS group; however, the difference in AOB closure between the groups was not statistically significant. This single-center randomized controlled trial received ethical approval from Alexandria University’s Research Ethics Committee, Alexandria, Egypt (IORG0008839, No. 0313 − 10/2021). This trial was retrospectively registered in the Pan African Clinical Trial Registry (PACTR202403582913859) on 14 March 2024.