Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants

Cheol-Hyun Moon; Joo-Sin Lee; Hyun-Sun Lee; Jin-Hugh Choi

doi:10.4041/kjod.2009.39.6.402

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Moon, Lee, Lee, and Choi: Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants

Case Report

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2009; 39(6): 402-419.

Published online: 31 December 2009

DOI: https://doi.org/10.4041/kjod.2009.39.6.402

Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants

Cheol-Hyun Moon, DDS, MSD, PhD^a, Joo-Sin Lee, DDS^b, Hyun-Sun Lee, DDS, MSD^c, Jin-Hugh Choi, DDS, MSD, PhD^d

^aProfessor, Department of Orthodontics, Gachon University Dental Hospital, Korea.

^bPublic Health Doctor, Korea.

^cPrivate Practice, Korea.

^dAssistant Professor, Department of Dentistry, Chung-Ang University College of Medicine, Korea.

Corresponding author: Cheol-Hyun Moon. Department of Orthodontics, Gachon University Dental Hospital, 1204, Guwol-dong, Namdong-gu, Incheon 405-760, Korea. +82 32 460 3881; orthodm@gilhospital.com

Received 1 December 2008 Revised 16 September 2009 Accepted 20 September 2009

Abstract

Successful treatment of the non-growing patient with an open bite of either dental skeletal pattern often presents a difficult challenge. The morphologic pattern in anterior open bite is characterized by longer vertical dimensions, an increase in development of the maxillary posterior dento-alveolar structure and a steep mandibular plane. In such cases, molar intrusion would be a good remedy for treatment. This article reports the successful treatment and retention of two anterior open-bite cases. We used orthodontic mini-implants for treatment and a circumferential retainer with posterior bite block or skeletal fixed retainer for retention. The diagnostic criteria and mechanics for appropriate treatment are discussed. Our results suggest that open bite can be reduced successfully with intrusion of molars using orthodontic mini-implants (OMI) without orthognathic surgery, and that circumferential retainer with posterior bite block and skeletal fixed retainer are effective for retention.

Keywords: Openbite, Orthodontic mini-implant, Posterior bite block, Skeletal fixed retainer

Figures and Tables

Fig. 1

Pretreatment facial and intraoral photographs.

Fig. 2

Pretreatment lateral cephalometric and panoramic radiograph.

Fig. 3

Intraoral photographs (6 months after start of treatment). Only intrusion of molars has allowed a positive overbite.

Fig. 4

Posttreatment facial and intraoral photographs (15 months after start of treatment).

Fig. 5

Posttreatment lateral cephalometric and panoramic radiograph.

Fig. 6

Retainer photographs (Mx. arch; circumferential retainer, Mn. arch; circumferential retainer with posterior bite block).

Fig. 7

20 months-retention intraoral photographs (8 months after circumferential retainer with posterior bite block removal).

Fig. 8

20 months-retention lateral cephalometric and panoramic radiograph.

Fig. 9

Superimposition of cephalometric tracings.

Fig. 10

Pretreatment facial and intraoral photographs.

Fig. 11

Pretreatment lateral cephalometric and panoramic radiograph.

Fig. 12

Transpalatal arch for intrusion of maxillary 2nd molar (TPA is kept apart from the palatal surface for intrusion of the maxillary 2nd molar).

Fig. 13

Intraoral photographs (5 months after start of treatment).

Fig. 14

Intraoral photographs (8 months after start of treatment).

Fig. 15

Posttreatment facial and intraoral photographs (28 months after start of treatment).

Fig. 16

Posttreatment lateral cephalometric and panoramic radiograph.

Fig. 17

Skeletal fixed retainer (SFR).

Fig. 18

13 months-retention intraoral photographs (1 month after SFR removal).

Fig. 19

27 months-retention intraoral photographs (15 months after SFR removal).

Fig. 20

Superimposition of cephalometric tracings.

Fig. 21

Superimposition of cephalometric tracings.

Table 1

Cephalometric measurements

Table 2

Maxillary 1^st molar change in sagittal plane

^*6/ANS-PNS, Angle between the first permanent maxillary molar and the palatal plane; ^†6/SN, angle between the first permanent maxillary molar and the anterior cranial base; ^‡6-CEJ/ANS-PNS: distance between the center of cementoenamel junction on sagittal plane of the first permanent maxillary molar and the palatal plane.

Table 3

Cephalometric measurements

Table 4

Maxillary 1^st molar change in sagittal plane

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