Comparing Skeletal and Dentoalveolar Effects of Fixed Palatal Crib and Bonded Spurs in Early Management of Anterior Open Bite Associated with Non-Nutritive Sucking Habits: A Randomised Clinical Trial

Purpose To assess how fixed palatal cribs and bonded spurs affect skeletal and dentoalveolar parameters during the management of anterior open bite induced by non-nutritive sucking habits Methods This study was a randomised clinical trial involving 30 patients ranging from 6 to 11 years with anterior open bite ≥ 1 mm, randomly allocated into two groups: fixed palatal crib (FPC, n = 15, mean age 8.6 years) and bonded spurs (BS, n = 15, mean age 8.3 years). Digital biomodels and lateral cephalometric images were obtained at the beginning of the trial and 12 months post-treatment to assess the changes. Paired and independent t-tests were used for intra- and intergroup comparisons, respectively. Results Intergroup analysis showed the FPC group achieved significantly greater overbite correction than the BS group (1.22 ± 2.18 mm, p  = 0.00387), with 73.33% achieving a positive overbite compared to 6.67% in the BS group. The FPC group also showed significantly higher increases in mandibular arch perimeter (2.57 ± 0.79 mm, p  = 0.00314), maxillary arch length (1.56 ± 0.35 mm, p  = 0.00013), mandibular arch length (1.62 ± 0.30 mm, p  = 0.00001), and intermolar width (0.71 ± 0.24 mm, p  = 0.00001). Cephalometric findings showed greater reduction in the lower central incisor mandibular plane angle (6.75 ± 1.65°, p  = 0.00032) and a corresponding increase in the interincisal angle (6.12 ± 2.61°, p  = 0. 02654), while skeletal measurements showed no statistically relevant variation between the two groups. Conclusion The fixed palatal crib appliance was more effective than bonded spurs in managing anterior open bite in growing patients, mainly via dentoalveolar changes like incisor retroclination, without affecting skeletal parameters. Trial registration This trial was registered at clinical trial.gov, ID NCT05313399.