Anterior Open Bite Closure Using Ortodontic Mini-implants - Anterior Open Bite Closure Using Ortodontic Mini-implants - Open Access Pub

This case report describes the treatment of a dento-alveolar protrusion with anterior open bite. The 21-year old patient had a convex profile , class I dental malocclusion , anterior open bite of 4 mm and presented tongue thrust. The treatment plan was to insert two mini-implants for premolar intrusion along with the straight –wire fixed appliances. Tongue therapy was performed by myofunctional exercises. Using the absolute anchorage we were able to achieve our goals in a predictable manner without the use of orthognathic surgery or patient compliance . After the tongue thrust habit was removed we are confident that this is a stable result . DOI10.14302/issn.2473-1005.jdoi-16-1326 Orthodontic mini-implants are now widely used to provide absolute anchorage because of their versatility , minimal invasiveness and low cost .1 Difficult orthodontic cases , like molar intrusion, molar uprighting , anterior open bite treatment with molar intrusion, anterior deep bite treatment with incisal intrusion, leveling of transverse tipping of the occlusal plane, asymmetric expansion, space closure are corrected without the need of extraction, orthognathic surgery or patient compliance.3 New mechanics based on absolute anchorage have expanded the variety of ortho-mecanoterapy .4 The most important change is that it becomes possible to intrude posterior teeth bilaterally with mechanotherapy alone.5 Diagnosis and Etiology The patient, a 21-year old woman , had a convex profile , class I dental malocclusion ,anterior open bite of 4 mm . She was a mouth breather and presented tongue thrust. Her chief complain was the anterior open bite .(Figure 1) Figure 1. Pretreatment intraoral photography The cephalometric analysis indicated that she had a skeletal class II profile ,proclination of the maxillary central incisor ,high mandibular plane angle that contributed to the class II skeletal relationship and increased lower facial height. Figure 2. Pretreatment cephalometric film The panoramic radiograph showed bilateral mandibular third molars. The level of alveolar bone crest was within the normal range. (Figure 3) Figure 3. Pretreatment panoramic X-ray Figure 4. Intraoral photography at the start of the treatment. Theories to explain the cause of anterior open bite: digital habits , airway obstruction, tongue posture, unfavourable growth, tongue trust .2 The patient presented tongue thrust and mouth breathing. She was reffered for myofunctional exercises for tongue thrusting before orthodontic mechanics began. Treatment Objectives ·To maintain class I molar and canine