Treatment of a twice-relapsed anterior open bite using temporary anchorage devices, myofunctional therapy, and fixed passive self-ligating appliances

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 157; no. 6; pp. 832 - 842
• Main Author: Miller, James Robert
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.06.2020
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2019.03.031

Maxillary LeFort impaction surgery can lead to improvements in facial proportions, smile esthetics, and improved function for patients with long lower facial height and anterior open bite. Sometimes, because of patient wishes, corrective jaw surgery might not be the most appropriate choice for treatment. This report describes the orthodontic retreatment of a 25-year-old woman with a history of 2 orthodontic treatments and 1 corrective jaw surgery, each with anterior open bite relapse. This third orthodontic treatment plan addressed her chief concern and focused on maximizing esthetics, function, and long-term stability. A problem list was used to design a treatment plan that incorporated myofunctional therapy, fixed appliances, and temporary anchorage devices to intrude her maxillary teeth and correct her orthodontic problems. Molar intrusion lasted 8.5 months, and total treatment time in fixed appliances lasted 22 months. The treatment was successful in addressing her chief concerns by shortening her lower facial third, relieving her lip strain, closing her anterior open bite, and achieving a Class I molar and canine occlusion. Overall, posttreatment stability was excellent at approximately 1-year follow-up, and the patient stated that she was very happy with the result. •A 25-year-old woman sought a third treatment for anterior open bite.•Previous treatment results, including 2-jaw corrective surgery, had relapsed.•Tongue thrust was diagnosed as the likely cause of the ongoing relapse.•The patient was treated with fixed appliances, miniscrew implants, and myofunctional therapy.•Treatment was successful, and posttreatment stability was excellent at 1-year follow-up.