Abstract
ABSTRACTIntroduction: Anterior open bite is one of the most difficult malocclusions to correct in orthodontic treatment. Molar intrusion using miniscrew anchorage has been developed as a new strategy for open bite correction; however, this procedure still has an important concern about prolonged treatment duration in the patient with anteroposterior discrepancy due to the separate step-by-step movement of anterior and posterior teeth. Objective: This article illustrates a comprehensive orthodontic approach for dentoalveolar open bite correction of an adult patient, by using miniscrew. Case report: A woman 19 years and 5 months of age had chief complaints of difficulty chewing with the anterior teeth and maxillary incisor protrusion. An open bite of -2.0 mm caused by slight elongation of the maxillary molars was found. The patient was diagnosed with Angle Class II malocclusion with anterior open bite due to the vertical elongation of maxillary molars. After extraction of the maxillary first premolars, concurrent movements of molar intrusion and canine retraction were initiated with the combined use of sectional archwires, elastic chains and miniscrews. Results: At 4 months after the procedure, positive overbite was achieved subsequent to the intrusion of maxillary molars by 1.5 mm and without undesirable side effects. Class I canine relation was also achieved at the same time. The total active treatment period was 21 months. The resultant occlusion and satisfactory facial profile were maintained after 54 months of retention. Conclusion: The presented treatment shows the potential to shorten the treatment duration and to contribute to the long-term stability for open bite correction.
Highlights
Anterior open bite is one of the most difficult malocclusions to correct in orthodontic treatment
Successful correction of anterior open bite is considered one of the most difficult task in orthodontics, and ensuring the long-term stability of the treatment outcome is an important factor to be considered when choosing the method of treatment for patients with anterior open bite.[1,2]
The overall treatment duration would be prolonged in cases of anterior open bite with anteroposterior discrepancy, as the anterior teeth would be moved after intrusion of the molars using other methods
Summary
Anterior open bite is one of the most difficult malocclusions to correct in orthodontic treatment. Molar intrusion using miniscrew anchorage has been developed as a new strategy for open bite correction; this procedure still has an important concern about prolonged treatment duration in the patient with anteroposterior discrepancy due to the separate step-by-step movement of anterior and posterior teeth. The patients treated with these modalities achieved adequate overbite, the changes were mainly caused by the extrusion of the anterior teeth, since molar intrusion is relative to incisors extrusion due to the intermaxillary elastics.[7] Such compensatory eruption of incisors is often undesirable for patients who have maxillary vertical excess, a long face, or excessive gingival display. The overall treatment duration would be prolonged in cases of anterior open bite with anteroposterior discrepancy, as the anterior teeth would be moved after intrusion of the molars using other methods
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