Orthotown June 2017 - 23
message board
MB Townie Name DT
Open Bite Treatment Plan Help
Member Since: 04/11/10
Post: 1 of 20
When a 31-year-old patient presents with an open bite,
this Townie heads to the boards for treatment advice.
crk
Introduction:
A 31-year-old male presented with the chief complaint "My dentist referred me for my bite."
Previous orthodontic treatment. Patient stated his bite was not completely closed, but he is not
very sure.
Tx findings: Skeletal and dental open bite, generalized root resorption, wear facets on posterior
teeth. Tx options: U/L braces + orthognathic surgery, TADs to intrude posterior teeth. Would
you consider Invisalign? Any feedback is greatly appreciated.
Thanks! ■
Member Since: 09/10/11
Post: 1 of 21
3/29/2017
Fenrisúlfr
Protrusive U/L incisors. I would consider extraction of all 5s and retraction to close the open bite. ■
3/29/2017
Member Since: 02/25/09
Post: 2 of 21
Dr-T
My gut feeling tells me only option 1 (surgical) will have the best chance at closing the open
bite. The one thing that is hard to determine on open bite cases is if they are in a "muscle braced"
centric occlusion position. More often than not the open bite is worse than it appears. ■
Member Since: 05/19/09
Post: 3 of 21
3/29/2017
danbraces
Just a thought but when you see the lower incisors reverse curve like they are I many times
think habit. Check for tongue, nail biting etc. Even if still surgery case, this has to be taken care
of or relapse. ■
Member Since: 11/09/08
Post: 4 of 21
3/30/2017
davidharnick
I kind of see this case differently, sorry. When I look at the ceph it does not appear to be a
skeletal open bite. The lips are competent, the occlusal plane is not steep, the ramus is not short,
the incisors lack display, no excess gingival display. The upper incisors lack display but the lowers
are severely depressed.
If protrusive I would call it mild and nonexistent if the patient is not unhappy in any way.
Dentally the maxillary teeth are tipped in. So, if this is my patient I would use Invisalign to
control the vertical and upright, retract upper incisors with mild dental expansion and IPR as
to cause, the lingual frenum appears very short and any habits need to be addressed, along with
appropriate myofunctional exercises. ■
Member Since: 08/28/02
Post: 5 of 21
3/30/2017
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