Abstract
Abstract Background This case report describes the orthodontic treatment of a 20 year-old female who presented with a severe anterior open bite, increased lower facial height and mandibular asymmetry. The patient was diagnosed with a Class I skeletal pattern but a Class III dental relationship, an anterior and unilateral posterior open bite, a canted posterior occlusal plane, a clockwise rotation and vertical growth pattern of the mandible incorporating a chin deviation to the right. Aim The aim of treatment was to correct identified adverse oral habits, improve the facial profile and mandibular asymmetry, provide a satisfactory occlusion and restore TMJ health, which could not be guaranteed. Methods An occlusal splint was used in the first stage of treatment to intrude the posterior teeth, eliminate the occlusal disturbance and control the adverse oral habits. Two micro-implant anchorage devices were placed on the buccal and lingual sides of the left buccal segment to further intrude the left posterior teeth. MEAW technology was used after aligning and levelling the teeth. Results Satisfactory overbite, overjet and molar relationships were obtained and the facial profile greatly improved after orthodontic treatment, the outcome of which was stable at 24 months’ review.
Highlights
An anterior open bite, often combined with an increased lower facial height, is known to be a challenging orthodontic problem
A severe open bite caused by divergent growth of Australasian Orthodontic Journal Volume 33 No 2 November 2017 the maxilla and mandible or abnormal resorption of temporomandibular joint (TMJ) can only be corrected by orthodontic treatment combined with orthognathic surgery
The choice of orthognathic surgical treatment was presented to the family but this plan was rejected and orthodontic treatment using an occlusal splint and micro-implant anchorage devices (MIAs) was adopted as an alternative
Summary
Often combined with an increased lower facial height, is known to be a challenging orthodontic problem. Patient profiles have been greatly improved without the risks of two-jaw surgery and the treatment outcomes have been shown to be stable.[4,5]. This case report describes the orthodontic treatment of a 20 year-old female who presented with a severe anterior open bite, increased lower facial height and mandibular asymmetry. Aim: The aim of treatment was to correct identified adverse oral habits, improve the facial profile and mandibular asymmetry, provide a satisfactory occlusion and restore TMJ health, which could not be guaranteed. Results: Satisfactory overbite, overjet and molar relationships were obtained and the facial profile greatly improved after orthodontic treatment, the outcome of which was stable at 24 months’ review. (Aust Orthod J 2017; 33: 258-267)
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