Customized lingual bracket system and skeletal anchorage system for open bite correction

Abstract

Open bite is one of the most difficult malocclusions for orthodontists to treat because this pathological condition reflects the involvement of multiple factors, including dental, skeletal, functional, habitual, neurogenic, and traumatic factors. [1,2] Therefore, for proper diagnosis and treatment, it is essential to perform the right tests and assessments, including determining the causal factors and planning an appropriate treatment that fully takes into account orthodontic treatment mechanics. [3] In other words, it is important to develop a treatment plan that pays careful attention to tooth extrusion and mesial movement in both the upper and lower molar regions, performs sufficient vertical and anchorage control, provides sufficient torque control of the anterior teeth, and incorporates myofunctional therapy (MFT) for excluding functional factors such as tongue thrust.As described in this case study, we treated an adult patient with open bite and high-angle mandibular retrognathism, by using customized lingual brackets in combination with a skeletal anchorage system (SAS) and orthodontic anchor screws (OAS), and carefully controlled torque, anchorage, and vertical factors. Here, we report the satisfactory outcome of treatment. dIAgnosIs And etIoLogyA 22-year, 5-month-old woman with a chief complaint of open bite in the anterior region with misaligned teeth visited our clinic. Present medical historyAt the age of 18 years (1 st year university student), her maxillary third molars began to erupt bilaterally, and around the same time, the formation and rapid progression of open bite were noted. At the age of 19 years, the woman visited the department of oral and maxillofacial surgery at a local medical center for the treatment of unpleasant sensations (trismus and pain) at the temporomandibular joint (TMJ). She was diagnosed with left TMJ dysfunction and underwent bilateral extraction of the maxillary third molars and of impacted mandibular third

Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect

“…For vertical control specifically, to avoid clockwise rotation of the mandible, an OAS was used for intrusion of the maxillary molar teeth and to avoid extrusion during treatment. [20][21][22][23] Because treatment could proceed without using Class II elastics, extrusion of the mandibular molars was kept to a minimum and counter-clockwise rotation of the mandible occurred.…”