Innovative Technique for Correction of Open Bite - A Case Report

Anterior open bite is defined as a condition in which upper incisor crowns fail to overlap the incisal third of the lower incisor crowns when the mandible is brought into full occlusion. The diagnosis, treatment, and successful retention of treated open-bite malocclusion continue to be a constant subject of discussion and study, contributing to the frustrations of clinicians. Various modalities have been used for the correction of open bite for the different age groups. In adult cases, an open bite can be corrected either by anterior extrusion or posterior intrusion, or a combination of both. Kim had described a method of using multiloop edgewise archwire for posterior intrusion. Here is a case report in which an innovative method is described which is a modification of Kim's method which is simpler, less time-consuming to place, hygienic, and they do not irritate the soft tissue. The bite closing mechanism and the treatment results are similar to Kim's method.

Evaluation of Soft and Hard Tissue Changes Following the Use of Rapid Molar Intruder for the Management of Skeletal Anterior Open Bite in Mixed Dentition: A Randomized Controlled Trial

Objective The aim of the study was to evaluate skeletal, dentoalveolar, and soft tissue changes following early anterior open bite (AOB) treatment using a rapid molar intruder (RMI). Materials and methods A two-arm, parallel-group, randomized controlled trial was conducted on 40 patients aged 8-12 years with anterior open bites. They were randomly allocated to the RMI group and the untreated control group (UCG) with a 1:1 allocation ratio. At the beginning of the treatment (T1) and after nine months of treatment (T2), lateral cephalometric images were taken of each patient. The primary outcome measures were skeletal, dentoalveolar, and soft tissue changes. A two-sample t-test was used in the intergroup comparisons of the cephalometric measurement. Results The findings showed that the overbite increased significantly in the RMI group compared to the control group (x = 4.44 mm, x = 0.19 mm, respectively; p<0.001). A statistically significant intrusion of the upper and lower first molars was observed in the RMI group (x = 2.9 mm, x = 1.54 mm, respectively) compared to a slight extrusion in the control group. The differences between the two groups were significant (p<0.001). The SN: GoMe angle and the sum of Bjork decreased significantly in the RMI group compared to an increase observed in the control group. The differences between the two groups were significant (p<0.001). Conclusion The rapid molar intruder is an effective appliance for correcting anterior open bites in mixed dentition, inducing favorable skeletal, dentoalveolar, and soft tissue changes.

Management of anterior open-bite in the deciduous, mixed and permanent dentition stage: a descriptive review

Anterior open bite is one of the most complex malocclusions to manage. The interaction of skeletal, dental, and soft tissue effects can contribute to develop an anterior open bite. The skeletal open bite requires a more complex approach of treatment to reach function, aesthetics, and stability. The approaches vary depending on the causative factors and the age of patients. Treatment approaches for open bite patients differ when dealing with adults and growing patients. The aim of this descriptive review was to summarize the main existing treatment strategies for anterior open bite, from the noninvasive behavioural shaping to the orthodontic intrusion with skeletal anchorage.

Long-term follow-up and treatment of a patient with severe skeletal open bite using temporary anchorage devices

This case report presents the treatment and long-term follow-up of a patient with severe skeletal hyperdivergent open bite, Class II malocclusion, and a severely retruded chin. After failure of early treatment using high-pull headgear with a bite block during the early permanent dentition stage due to an unfavorable growth pattern, orthognathic surgery was proposed but rejected by the patient. Then, temporary anchorage devices were used to correct the occlusion and establish an acceptable overbite and overjet. The overall observation time was 8.5 years; the treatment time using fixed appliances was 3 years and 4 months. The achieved tooth position and occlusal relationship remained stable 2.5 years later without recurrence of the open bite.

Skeletal anchorage for intrusion of bimaxillary molars in a patient with skeletal open bite and temporomandibular disorders

The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of −2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite.

Molar height and dentoalveolar compensation in adult subjects with skeletal open bite

OBJECTIVE

To evaluate the skeletal and dentoalveolar components in adult subjects with skeletal open bite in the presence or absence of dental compensation.

MATERIALS AND METHODS

The study sample included 69 adult female subjects who belonged to three groups according to skeletal vertical relationships and overbite. A total of 15 variables (5 angular, 10 linear) were evaluated. Values in the dentally compensated open bite group (COBG), the dentally noncompensated open bite group (NCOBG), and the control group with normal vertical skeletal relationships and overbite (CG) were compared by means of parametric statistics.

RESULTS

The COBG and the NCOBG showed significantly greater incisor and molar heights in both jaws than the CG. No significant difference in upper or lower molar height was found between COBG and NCOBG. Incisor height was significantly greater in COBG than in NCOBG. Elongation in the incisor region was accompanied by significant narrowing of the lower anterior alveolar process in both skeletal open bite groups. Proclination of the upper incisors was significantly smaller in the COBG than in the other groups.

CONCLUSIONS

Dentoalveolar components consisting of incisor elongation and inclination play a significant role in compensating for skeletal open bite configuration in adult subjects. Increased molar height is a common finding in adults with skeletal open bite.