Combining traditional techniques to correct anterior open bite and posterior crossbite

Contemporary management of an orthodontic-orthognathic patient with limited time availability in an orthodontic office setting: Case report

INTRODUCTION

This case report describes the treatment of a 21-year-old man who presented in an orthodontic office for treatment but lived in a city 100 miles away and wanted the orthognathic surgery in another state in America. The patient presented with an anterior open bite and skeletal Class III relationship.

METHODS

The treatment plan included: (1) effective and careful communication of the treatment plan with the patient, orthodontist and oral and maxillofacial surgeon; (2) pre-surgical alignment and levelling of the teeth in both arches with Invisalign; (3) a long-distance communication between the orthodontist and the surgeon for surgical plan with virtual surgical planning (VSP Orthognathics; 3D Systems, www.3Dsystem.com) online; (4) maxillary advancement (LeFort I osteotomy) with mandibular set-back (bilateral sagittal split osteotomy); (5) postsurgical correction of the malocclusion with clear brackets and aligners; and (6) retention and final small tooth movement adjustments with aligners/clear retainers.

RESULTS

The anterior open bite was treated, crowding was eliminated in the upper and lower anterior segment, correction of skeletal and dental Class III malocclusion was obtained, mandibular plane angle was reduced and facial profile improved.

CONCLUSIONS

The results suggest that aesthetic and functional results can be achieved with long-distance communication of two specialties and with the combined use of clear aligners and clear fixed appliances.

Nonsurgical treatment of severe Class II malocclusion with anterior open bite using mini-implants and maxillary lateral incisor and mandibular first molar extractions

This clinical case report presents the nonsurgical orthodontic treatment of a patient with skeletal Class II malocclusion, posterior crossbite, anterior open bite, accentuated dental discrepancies in both arches, and an odontoma. The proposed treatment involved maxillary expansion, extraction of atypical maxillary lateral incisors and mandibular first molars, and intrusion of maxillary teeth with the aid of mini-implants. The results obtained with these procedures included good tooth alignment, normal overbite and overjet, removal of the odontoma, and a harmonious smile. In complex cases, an accurate diagnosis is the key to a favorable outcome.

The effect of orofacial myofunctional treatment in children with anterior open bite and tongue dysfunction: a pilot study

OBJECTIVES

Insufficient attention is given in the literature to the early treatment of anterior open bite (AOB) subjects receiving orofacial myofunctional therapy (OMT), which aims to harmonize the orofacial functions. This prospective pilot study investigates the effects of OMT on tongue behaviour in children with AOB and a visceral swallowing pattern.

MATERIALS AND METHODS

The study comprised of 22 children (11 boys, 11 girls; age range: 7.1-10.6 years). They were randomly assigned into OMT and non-OMT subjects. The randomization was stratified on the presence of a transversal crossbite. At baseline (T0), at the end of treatment (T1) and at 6 months after T1 (T2) maximum tongue elevation strength was measured with the IOPI system (IOPI MEDICAL LLC, Redmond, Washington, USA). Functional characteristics such as tongue posture at rest, swallowing pattern and articulation and the presence of an AOB were observed.

RESULTS

OMT did significantly change tongue elevation strength, tongue posture at rest, and tongue position during swallowing of solid food. At T2 more OMT subjects had contact between the lower central incisors and their antagonists or palate (P = 0.036). More OMT subjects performed a physiological pattern of water swallowing than non-OMT children at T1 and T2, although the differences were not significant. Articulation of /s,l,n,d,t/ was not improved by OMT. No interaction between OMT and expansion was found for any of the parameters.

CONCLUSION

OMT can positively influence tongue behaviour. However, further research is recommended to clarify the success of OMT as an adjunct to orthodontic treatment and to identify possible factors influencing the outcome.