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A significant Class III skeletal discrepancy with open bite and excessive lower facial height is presented. The malocclusion was treated with a combination of orthodontics and orthognathic surgery.
In a 21-year-old man with open bite, myogenic headache and internal derangement of the temporomandibular joint clinical examination was supplemented by radiographs of the joints, cephalometric analysis, electromyographic recordings of the masticatory muscles and tracking of mandibular movements. His condition was characterized by reduced occlusal stability with contact limited to posterior molars, and weak elevator muscles with increased strain during posture and chewing. The purpose of the treatment was to eliminate symptoms with a reflex-releasing stabilizing splint. Secondly, to increase occlusal stability, primarily with the splint and later through orthodontic treatment aiming at closing the bite in the premolar region because the reduced occlusal stability seemed to be a significant etiologic factor. Treatment with the splint reduced signs and symptoms of craniomandibular disorders. During the following orthodontic treatment, contact was established on both premolars and molars, mainly due to extrusion of mandibular premolars. Analysis showed greater elevator strength and decreased muscular loading after treatment. A splint was used for retention accompanied by muscle training with exercise gum. Permanent training with gum was recommended after the retention period.
A cephalometric study of 46 cases of both sexes, with open bite (experimental group), aged 10 to 18 years, was performed. The control group consisted of 180 cases with normal occlusion. A total, of 38 linear and angular variables were analyzed. Age variable as well as sex-related differences were also estimated. Compared with the control group, experimental group demonstrated significantly higher mean values for the following variables: lower segment of the mandibular angle, mandibular angle, basal angle, Bjork's polygon, mandibular anterior cranial base planes angle and Y-axis angle. The proportion between the facial hights was significantly decreased in the experimental group. In addition, retroclination of the lower incisors was significantly higher in the experimental than in the control group. Only four linear variables showed significant sex-differences. It may be concluded that there are no significant sex difference for most of morphological characteristics of the viscerocranium.
A case of anterior open bite secondary to occlusal splint therapy in the adult is described. The occlusal splint covered all maxillary teeth, including the third molars. A brief discussion of the findings and treatment considerations is presented.
This case report describes the treatment of a patient with three unerupted mandibular right molars and a lateral open bite in a Class II subdivision malocclusion with mandibular arch asymmetry. Sequential uprighting and traction of the three mandibular unerupted teeth with a compressed open-coil spring, reverse sliding jig, and light force system was used in the treatment and are described in detail. The results remained stable during the 8-year 6-month posttreatment and 4-year postretention periods.
Successful treatment of severe skeletal open-bite malocclusions has always demanded the utmost of the orthodontist. Long-term evaluation of this type of treatment is not often seen in the literature, for the results have often been disappointing. Combining the best of the surgical and orthodontic disciplines offers these cases an optimistic outlook for the first time. A case treated twice by conventional orthodontic means in 1965 and 1969 was re-treated in 1980 by a surgical orthodontic approach. The results are quite encouraging.
The treatment of a skeletal Class III open bite malocclusion with Turner's syndrome is described. Although the patient had a negative overbite of 9 mm, a positive overbite of 2 mm was obtained through treatment, without any tooth extractions; however, an excessive vertical growth of the anterior regions was noted.
The cephalometric characteristics of skeletal anterior open bite (AOB) in a southern Chinese population were evaluated in a group of 104 subjects with AOB and were compared with a control group of 40 subjects without AOB. The anteroposterior jaw relationship in the AOB group was Class I in 43%, Class II in 14%, and Class III in 43%. Cephalometric analysis of all subjects was completed by using 24 skeletal and 12 dentoalveolar measurements. Sexually dimorphic variables were identified and compared separately between groups with independent t tests. Two levels of significance were used, P < or = 0.05 and P < or = 0.001. Sexual dimorphism of cephalometric variables was present in both the test and the control groups, but affected more variables in the test group. Significant findings in AOB were shorter anterior cranial base, upward and forward rotation of the maxilla, increased gonial and mandibular plane angles, increased upper posterior dental height, and increased lower anterior facial height. These findings generally coincided with those for white subjects, however, there was no conclusive evidence in this study regarding the contribution of the upper anterior facial height or the posterior facial height to the AOB deformity.
The effect of crib therapy for the treatment of cases of open bite was investigated. Extrusion of the lower and upper incisors and intrusion of the lower first molars were the most significant effects of the appliance. Intrusion of the lower molars resulted in decreased lower facial height. These findings were considered to result from the posterior tongue posture. Thus, the clockwise pattern of the mandibular complex was changed to a counter-clockwise pattern.
AOB can be acquired or skeletal in nature. Treatment of skeletal open bites can be difficult, especially with fixed appliances. Magnetic biteblocks have recently gained popularity. Surgery may be necessary in the patient with a severe skeletal discrepancies and usually involves differential maxillary impaction.
Activator therapy for a severe Class II, Division 1 malocclusion with open bite malocclusion is described. The treatment was performed in three stages: one, "early-early," at the age of 5 to 6 years; one "early," between 9 and 11 years; this was followed by 2 years of retention with a maxillary retainer. The patient continued to be observed further over a 3-year period. The final records show a normal, stable occlusion, and good facial balance.
Two sisters are presented in whom posterior open bites have developed. Orthodontic treatment was not successful in correcting this aspect of the malocclusion in the older sibling. The younger child developed the same defect, and consequently orthodontic treatment is not being considered.
Morphological and functional symptoms of various varients of the open bite are reported on. The orthodontic treatment possibilities and, then, the surgical methods applicable after termination of jaw bone development are summarized. The functional disturbances have to be considered in case of both the conservative and the surgical treatment. A patient treated with a fixed device and an operated patient are presented.
In the present study different types of "open-bite" have been taken under consideration. First of all, have been analysed the main etiopathogenetic factors which are the causes of the malformation in sphere of various classifications.
A patient with anterior open bite is studied. Treatment and technique selected for the surgical correction of his deformity is described. It is stated that on account to the socialist character of our medical assistance, this treatment is within reach of any patient requiring it. Finally, emphasis is made on the fact that control after surgery is as important as a right selection and performance of the technique used for the prevention of relapses.
This study was carried out to determine the level of attractiveness of anterior open bites (AOB) and reverse overjets of varying severity. A sample of 180 non-dental students (101 females and 79 males; average age 20 +/- 0.75 years) and 45 dental professionals (12 females and 33 males; average age 35.5 +/- 5.07 years) was asked to complete a questionnaire to rate the level of attractiveness of AOB and reverse overjets of varying severity using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Photographs of mild and severe AOB and reverse overjets were projected onto a white screen in a lecture theatre (15 seconds each with a 5 second interval between images). The participants were asked to record the AC grade at which they thought the projected picture of the AOB or reverse overjets had similar attractiveness. Dental awareness of non-dental students was determined by asking them their opinion on how important it was to have straight teeth (very unimportant, unimportant, important, very important), about their personal or close family members' orthodontic experiences and if they thought they were in need of any orthodontic treatment. A chi-square test was applied to record any differences between sexes and between the different groups. Backward stepwise linear regression analysis was used to determine the relationship between the students' ratings of the photographs and their dental awareness. The majority of non-dental students rated a mild AOB (93 per cent) and mild reverse overjet (96 per cent) to be aesthetically acceptable. A mild AOB and mild reverse overjet were found to be acceptable by 40 and 58 per cent of dental professionals, respectively. The differences in the ratings between dental professionals and non-dental students were significant at P < 0.001.A severe AOB was considered unattractive by both students and dental professionals. However, dental professionals rated it at the more unattractive end of the scale (P < 0.001). A severe reverse overjet was rated by the majority of the subjects as aesthetically unacceptable (85 per cent of the non-dental students and 78 per cent of the dental professionals).
A case of amelogenesis imperfecta with hypoplasia, hypocalcification of the enamel, congenital absence of teeth 12 and 22, delayed eruption of tooth 23, edge-to-edge incisal relationship, open bite, and bilateral posterior cross bite at the level of the first and second premolars is presented. Lateral skull teleradiography indicated a Class III skeletal pattern of maxillary origin associated with a dolichofacial pattern with multiple indicators of facial hyperdivergence. The patient presented a major esthetic abnormality of the face and required orthodontic treatment prior to a prosthetic solution with full-coverage metal-ceramic crowns in both the maxilla and the mandible. The diagnosis of cases such as this one and the therapeutic implications from an orthodontic and prosthetic standpoint are reported.
The patient had a Class I (Angle) malocclusion characterized by an anterior open bite, bimaxillary dental protrusion, posterior and anterior crossbites, and mandibular midline deviation. A nonextraction treatment was followed for this patient. A Begg appliance (0.020 inch) and a posterior high-pull headgear were used. The prognosis was good because of the rather favorable skeletal pattern of the patient. The active treatment lasted 12 months. The patient was retained with a positioner. The occlusion was stable at 2 years posttreatment.