Abstract
Abstract Aim To present the treatment and long-term post-treatment results of an adult case presenting with an Angle Class II anterior openbite malocclusion that involved the use of zygomatic anchorage for the intrusion of the maxillary posterior teeth. Methods A 23-year-old female patient with a bilateral Angle Class II molar and canine relationship, a 4 mm overjet and a 6 mm anterior open-bite was treated using zygomatic anchorage in order to correct the dental and skeletal relationships, and eliminate the anterior open-bite to achieve an ideal overjet, overbite and improved facial aesthetics. Orthodontic brackets were placed on the maxillary and mandibular teeth. Under local anaesthesia, a subperiosteal flap was raised, and two titanium miniplates were bilaterally placed in the zygomatic area. The molars were intruded by applying 400 grams of force to the miniplates via connection to the upper arch wire. Results By intruding the molar teeth using zygomatic anchorage, the anterior open-bite was corrected to achieve an Angle Class I occlusion, an ideal overbite and a harmonious facial profile that were successfully maintained after a 10-year follow-up period.
Highlights
Skeletal open-bite malocclusions are characterised by increased lower facial height and a steep mandibular plane angle caused by over-erupted maxillary posterior teeth.[1,2,3,4] Successfully treating and maintaining the correction of poor vertical relationships can be challenging, especially in adult cases
The literature describes a range of orthodontic treatment options, most of which are focused on extruding incisors and/or preventing the eruption of posterior teeth.[5,6,7]
Several clinical methods have been developed as an alternative to orthognathic surgery for the intrusion of maxillary posterior teeth.[12]
Summary
Skeletal open-bite malocclusions are characterised by increased lower facial height and a steep mandibular plane angle caused by over-erupted maxillary posterior teeth.[1,2,3,4] Successfully treating and maintaining the correction of poor vertical relationships can be challenging, especially in adult cases. With or without mandibular ramus osteotomy, can be used to intrude maxillary posterior teeth and reduce lower facial height,[8] patients often refuse surgery because of the associated risks and high costs. The literature describes a range of orthodontic treatment options, most of which are focused on extruding incisors and/or preventing the eruption of posterior teeth.[5,6,7] Several clinical methods have been developed as an alternative to orthognathic surgery for the intrusion of maxillary posterior teeth.[12] Treatment with extra-oral appliances is associated with a number of disadvantages, such as pain, poor aesthetics, and difficulties with patient compliance. Onplants,[13] miniscrews,[14] miniimplants,[15] palatal implants,[16] endosseous implants[17] and miniplates have been introduced to eliminate these problems.[10,18,19] Implants used for molar intrusion are most commonly placed in the anterior palate, buccal or palatal interdental alveolar bone or in the zygomaticomaxillary buttresses.[20]
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