Open bite correction Open bite malocclusion

1 open bite correction

1.1 primary/mixed dentition

1.1.1 behavior modification
1.1.2 tongue crib therapy
1.1.3 blue grass appliance
1.1.4 vertical pull chin cup


1.2 permanent dentition

1.2.1 high-pull headgear
1.2.2 elastics
1.2.3 bite blocks
1.2.4 glossectomy
1.2.5 orthognathic surgery

open bite correction
primary/mixed dentition
behavior modification

behavior therapy important when kids in primary dentition in pre-adolescent age. improving habits @ time may lead self-correction of open bite in many cases. presence of infantile swallowing childhood may lead anterior open bite in patients. habit control through appliances such tongue crib or tongue spurs may used in adolescent ages if behavior modification fails stop habit.

tongue crib therapy

tongue crib removable applianced placed in maxillary arch purpose of stopping tongue thrusting habit. appliance maybe used in patients mixed dentition or permanent dentition. tongue crib attached through bar 2 bands placed on upper 1st molars. crib shaped horseshoe metal bars prevent thrusting habit. tongue crib known eliminate habits in 90% of patients. (citation needed). huang et al. published study in 1990 stated patients achieved positive overbite during tongue crib therapy had chance of maintaining overbite after orthodontic treatment. credited change change in posterior positioning of tongue due crib therapy.

some of side-effects of using tongue-crib therapy appliance may trap lot of food may cause inflammation around appliance. in addition, repeated contact of tongue appliance may lead imprint on tongue self-resolve once appliance removed. important note type of therapy work in patients not have skeletal open bite tendency. skeletal open bite tendency may addressed via surgery or other treatments depending on severity.

blue grass appliance

it s type of appliance similar nance appliance, instead of acrylic pad rests on anterior palate, appliance has plastic roller patient can use tongue break habit. appliance banded upper 1st molars , bars extend appliance anterior palate plastic roller placed.

vertical pull chin cup

hakan iscan , others used vertical pull chin cup in 17 patients 9 months applied 400g of force on each side. compared controls, found patients included in experimental group had increased eruption of mandibular incisors, decrease of ramal inclination, decrease of mandibular plane, increase of overbite, decrease of gonial angle , increase of mandibular corpus inclination found. stated vertical chin cup maybe effective in treating skeletal open bite patients. however, pedrin et al used removable plate palatal crib , combined high-pull chin cup in 30 patients 12 months , compared 30 patients followed no treatment. found no positive skeletal influence on vertical facial pattern of patients treated open bite in mixed dentition stated protocol. study stated there no positive effect of vertical pull chin cup in controlling vertical facial height , close of anterior open bite done dentoalveolar changes.

permanent dentition

correction of open bite in permanent dentition may involve extrusion of anterior teeth or intrusion of posterior teeth. decision depends on incisor show on smiling patient. if patient has normal incisor show @ rest smile, molar intrusion may done in these type of faces. extrusion of anterior teeth in these patients lead excessive gummy smile in cases not desirable. if patient not have normal incisor show @ rest , smile, anterior extrusion may done in these patients.

high-pull headgear

this appliance can used patients growing , in permanent dentition. appliance has been advocated used controlling vertical dimension applying force intrude molars.

elastics

elastics have been used correct anterior dental open bite. these elastics can in configuration of triangular or anterior vertical elastics.

bite blocks

r. kuster , b. ingerval in 1992, used 2 types of bite blocks evaluate effect on skeletal open bite patients. 1 group of patients had spring-loaded bite block 1 year , other group had repelling magnets bite blocks 3 months. both type of bite blocks exerted intrusive force on both upper , lower posterior teeth. saw 3mm improvement in overbite magnet group , 1.3mm improvement in overbite spring-loaded group. concluded affect resulted due counter-clockwise rotation of mandible caused intrusion of posterior teeth , increased eruption of incisors.

glossectomy

there not systematic reviews or randomized clinical control trials related correction of open bite partial tongue glossectomy several case reports have been published indicating successful treatment of open bite surgical approach. macroglossia has been reported cause open bite , bimaxillary protrusion , known make orthodontic treatment unstable after completion.

orthognathic surgery

an orthognathic surgical approach can taken correct open bite once vertical growth has finished in male , female patients. @ time, le-fort osteotomy impact maxilla done. according proffit et al, surgical movement involves maxillary impaction stable surgical movement in hierarchy established. 2 jaw surgery can performed bilateral sagittal split osteotomy can done correct antero-posterior changes of mandible. however, 2 jaw surgery relapse leading bite opening may happen due condylar remodeling , resorption.