Correction of severe open bite using miniscrew anchorage

Treatment for Severe Class II Open Bite Using a Bonded Hyrax Expander, IZC Mini-Implants, and MEAW Technique in an Adolescent Patient

This case report describes the successful 3D treatment of a patient with a narrow maxilla and a severe class II open bite using a combination of a bonded hyrax expander, infrazygomatic crest mini-implants, and the multiloop edgewise arch-wire (MEAW) technique. A 14-year-old female with a thumb-sucking habit in childhood, presented with a severe open bite, a convex profile, and an obtuse nasolabial angle. Diagnosis revealed a skeletal Class II open bite with moderate crowding in the maxillary and mild crowding in the mandibular arch. Treatment objectives included eliminating the open bite, achieving normal overbite and overjet, and improving upper incisor visibility. Treatment involved the use of a bonded rapid palatal expansion device, mini-implants for maxillary intrusion, fixed appliances, vertical elastics, and a MEAW. Treatment results showed resolution of the open bite, improvement in overbite and overjet, achievement of Class I molar and canine relationships, and improved upper incisors visibility. Fixed appliances were used for the whole 22-month therapy period, and post-treatment records demonstrated that the treatment's objectives were met.

Successful and stable orthodontic camouflage of a mandibular asymmetry with sliding jigs

The purpose of this paper is to present and discuss a simple and low-cost clinical approach to correct an asymmetric skeletal Class III combined to an extensive dental open bite that significantly compromised the occlusal function and smile aesthetics of an adult male patient. The patient did not accept the idealistic surgical-orthodontic treatment option, neither the use of temporary anchorage devices to facilitate the camouflage of the asymmetrical skeletal Class III/open bite. Therefore, a very simple and inexpensive biomechanical approach using sliding jigs in the mandibular arch was implemented as the compensatory treatment of the malocclusion. Although minor enhancements in facial aesthetics were obtained, the occlusal function and dental aesthetics were significantly improved. Furthermore, the patient was very satisfied with his new smile appearance. Some advantages of this treatment option included the small invasiveness and the remarkably low financial costs involved. Moreover, the final results fulfilled all realistic treatment objectives and the patient's expectations. Results remained stable 5 years post-treatment demonstrating that excellent results can be obtained when simple and low cost, but well-controlled mechanics are conducted.