Abstract
AbstractRecently, skeletal anchorage devices have been used as anchorage units for upper molar intrusion as a way of correcting an anterior open bite malocclusion. To avoid the surgical procedures associated with the placement of miniplates in the zygomatic area, mini-implants may be inserted palatally or buccally in the alveolar process. However, consideration must be given to the potential risks of root damage and a higher failure rate associated with the placement of temporary anchorage devices (TADs) in the interradicular area. The anterior hard palate provides a safer and more stable alternative for TAD placement. The current paper describes the biomechanical principles and the clinical procedures of ‘Mousetrap’ mechanics using mini-implants in the anterior palate for upper molar intrusion. The stomatognathic response of maxillary molar intrusion is an autorotation of the mandible and so the sagittal implications for each patient must be considered. The presented patient demonstrates successful correction and stability of the treatment result at a three-year review.
Highlights
An anterior open bite is a challenging malocclusion to successfully address.[1]
The presented case report describes the successful correction of an open bite malocclusion that could have alternatively been addressed by surgical repositioning of the maxilla
The intrusion of the maxillary molars and subsequent autorotation of the mandible led to the closure of the anterior open bite malocclusion
Summary
An anterior open bite is a challenging malocclusion to successfully address.[1]. Patients presenting with a skeletal open bite may have a hyperdivergent facial pattern, an accompanying increase in lower anterior facial height and divergent maxillary and mandibular occlusal planes. The anterior palate provides for a suitable alternative insertion site where mini-implants with larger dimensions and higher stability[31,32] may be placed in a region with a high bone quality, thin overlying soft tissue and negligible risk of causing interference with nearby teeth.[33] The ‘Mousetrap’ intrusion device, using TADs in the MOLAR INTRUSION WITH THE ‘MOUSETRAP’APPLIANCE anterior palate, was introduced for intrusion of supraerupted upper molars.[34] In addition, the ‘Mousetrap’ can be used to correct an anterior open bite malocclusion. A modified Goshgarian TPA with a distal loop is fitted with sufficient clearance between the palatal mucosa to avoid impingement and irritation during and after successful molar intrusion
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