Taming Anterior Open Bite with Mini Screws

This case report presents the treatment of a patient with anterior open bite and treated with straight archwire sequence for initial alignment and leveling of the arches. The technique of using segmental arches allowed anterior extrusion and posterior intrusion combined with anterior elastics. The addition of intrusion forces of the posterior segments, based on bone anchorage with mini-screws placed on the buccal posterior segments, was introduced to allow a better control and result of the orthodontic treatment.

Treatment of anterior open bite in older adolescents is filled with difficult to resolve issues. The primary cause of the condition is difficult to diagnose and treat. Habits such as tongue thrust, fingers or other items in the mouth and prolonged use of pacifiers have been blamed. Another important cause is partial airway obstruction. This may force the patient to have an anterior lower positioned tongue with little molar contact that will stimulate formation of a narrow deep palatal vault, posterior crossbite, and supra-eruption of the molars, creating a permanent anterior open bite. Some patients have an anterior open bite due to a genetic predisposition with no other apparent cause.