Early treatment for anterior open bite: Choosing adequate treatment approaches

Abstract

Anterior open bite is considered one of the most challenging malocclusions to correct, especially regarding stability. There are numerous publications on the subject but with controversial information. Disagreements occur in most aspects of this malocclusion, such as the definition of an open bite, its etiological factors, treatment timing, and ideal treatment alternatives. The lack of consensus on the etiology of anterior open bite has led to different treatment approaches, which may explain the high rate of post-treatment instability. Furthermore, the etiological factors of this malocclusion typically result in myofunctional imbalance, which alters the harmony of muscular forces responsible for maintaining an adequate occlusion. Nevertheless, the literature indicates a scarcity of scientific evidence that myofunctional therapy helps to correct open bites. In addition, there is evidence that eliminating deleterious habits allows spontaneous overbite correction and brings physiological and psychological benefits to the child. Considering the possibility of a spontaneous reduction of this malocclusion with age, it is understood that not every child needs early treatment. To avoid overtreatment, the choice for intervention should assess possible causes and severity, the patient's age, and parental concerns. Therefore, this paper discusses possible early treatment approaches for anterior open bite.