• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.4
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• pp.188-192
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• 2013

Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three operations under general anesthesia and rubber traction. Although the open bite showed some improvement by the repeated operation, the occlusion was still unstable six weeks after the initial treatment. To eliminate the residual anterior open bite, BTX-A was injected into the anterior belly of the digastric muscle. Following injection of BTX-A, the anterior open bite showed immediate improvement. Complication and relapse were not observed during follow-up. Long-standing post-traumatic open bite could be successfully corrected by injection of BTX-A into the anterior belly of the digastric muscle without complication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.5
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• pp.284-294
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• 2012

Objectives: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). Materials and Methods: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). Results: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. Conclusion: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.355-364
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• 2008

Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.

• The korean journal of orthodontics
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• v.15 no.1
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• pp.115-121
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• 1985

This study was intended to investigate the effect of mesiodistal crown widths of the anterior teeth on the incisor relationship and to determine whether incisor width ratio and anterior width ratio could be used to assess interarch tooth width harmony. From the casts taken from 63 subjects, 26 of open bite, 18 of deep bite and 19 of normal over bite with age of 17-20, mesiodistal crown widths of maxillary and mandibular 6 anterior teeth were measured with Boley gauge. On the basis of tooth measurements, anterior and incisor width ratio were calculated. The cephalograms were taken from same subjects to measure the degree of over bite and over jet and to compare the craniofacial bony structures between open bite, deep bite and normal over bite. Correlations among the anterior width ratio, incisor width ratio, over bite and over jet were calculated. The results were as follows. 1. There were no differences in mesiodistal widths of anterior teeth, incisor width ratio and anterior width ratio between open bite, deep bite and normal over bite. 2. The incisor width ratio and anterior width ratio can be useful in the assessment of tooth width harmony because the incisor width ratio and anterior width ratio were stable statistically and significantly correlated with each other. 3. Over bite and over jet were not correlated with incisor width ratio and anterior width ratio.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.241-246
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• 2017

Purpose: The aim of this study was to compare the root surface areas of the maxillary permanent teeth in Thai patients exhibiting anterior normal overbite and in those exhibiting anterior open bite, using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of maxillary permanent teeth from 15 patients with anterior normal overbite and 18 patients with anterior open bite were selected. Three-dimensional tooth models were constructed using Mimics Research version 17.0. The cementoenamel junction was marked manually. The root surface area was calculated automatically by 3-Matic Research version 9.0. The root surface areas of each tooth type from both types of bite were compared using the independent t-test (P<.05). The intraclass correlation coefficient was used to assess intraobserver reliability. Results: The mean root surface areas of the maxillary central and lateral incisors in individuals with anterior open bite were significantly less than those in those with normal bite. The mean root surface area of the maxillary second premolar in individuals with anterior open bite was significantly greater than in those with normal bite. Conclusion: Anterior open-bite malocclusion might affect the root surface area, so orthodontic force magnitudes should be carefully determined.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.20.1-20.7
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• 2020

Background: Anterior open bite is a challenging malocclusion to correct orthodontic treatment. Anterior open bite associated with over-erupted posterior teeth and long lower facial height should be treated by reduction of posterior dimension for esthetic results. Although the possibility of orthodontic treatment of an anterior open bite has increased with the introduction of skeletal anchorage, there are still cases requiring surgery for various reasons. Case presentation: This case report covers an anterior open bite of a 25-year-old man successfully treated with the posterior maxillary segmental osteotomy (PMSO) and miniplates. After the pre-surgical orthodontic treatment, the PMSO between canines and first premolars was performed under local anesthesia and miniplates were placed on the zygomatic buttress. As a result of 28 months of treatment, an impaction amount of 3.5 mm was obtained in the maxillary posterior teeth, and the facial esthetics improved at rest and smile. Conclusion: The impaction of the posterior dentoalveolar segment using the PMSO can be a good treatment option in patients with anterior open bite showing long lower facial height.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.379-385
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• 1998

A patient with TMJ osteoarthritis and anterior open bite was treated with an intermaxillary traction device. Pretreatment examination revelaed a pain in both TMJ during mouth opening, moderate tendernesso f left sternocleidomastoid and right trapezius muscles. Anterior open Bite was aobserved with interincisal distance of 2mm. Tomograms and MRI showed anterior disc displacement withouit reductoin of both temporomandibular joints, and the condyles were flattened and slightly eroded. A pair of full-coverage occlusal appliances was made on both maxillary and mandibular dentition, with pivoting fulcrum on the site of the second moalr. Traction force was gained by the intermaxillary orthodontic elastics which were hooked by orthodontic brackets on the labial surfaces of the upper and lower anterior and premolar teeth. After 8 weeks of traction treatment, the joint pain was subsided completely and the anterior open bite was closed to get an edge to edge relationship of anterior teeth.

• The korean journal of orthodontics
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• v.16 no.1
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• pp.35-49
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• 1986

Etiologies and traditional treatment modalities regarding anterior open-bite were discussed to elucidate the advantages and disadvantages. And an emphasis was placed on the understanding of the true nature of anterior open-bite. Most anterior open-bite malocclusions can be treated with a high degree of sucess and stability without surgical intervention with the congnizance of the anatomy, the physiology and the dynamics of orthodontic mechanotherapy. In this regard, a Multiloop Edgewise Arch Wire (MEAW) Technic, which has been developed during the past twenty years by Dr. Kim, was introduced. Three cases with anterior open-bite malocclusion were presented to demonstrate the mechanotherapy.

• The korean journal of orthodontics
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• v.11 no.2
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• pp.109-123
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• 1981

The author studied and analyzed statistically 112 adults female ranging in age from 18 to 20 years with normal occlusion, 56 adults female ranging in age from 18 to 24 years with deep overbite and 53 adults female ranging in age from 18 to 28 years with open bite by vertical cephalometric analysis. The results were as follows; 1. In comparing normal occlusion with deep overbite and open bite, skeletal linear measurements were more significant than dentoalveolar linear measurements. SN-MP angle, SN-OP angle, PP-OP angle and Xi angle (ANS-Xi-Pog) were significant in anglular measurements. 2. Upper posterior facial height (SE-PNS), upper anterior alveolar height, lower posterior alveolar height, lower posterior alveolar height/lower anterior alveolar height and SN-PP angle were non significant between deep overbite and open bite. 3 The most significant items between deep overbite and open bite were lower anterior facial height (ANS-ME) and SN-MP angle. 4. Correlation coefficients of angular measurements were higher in deep overbite, while that of linear measurement total anterior facial height (N-ME) was higher in open bite. 5. In the multiple regression equation, significant variables were total anterior facial height (N-ME), lower anterior alveolar height, upper anterior alveolar height, upper posterior alveolar height, Xi angle (ANS-Xi-Pog) and ramus height (AR-Go) in deep overbite, and total anterior facial height (N-Me), lower anterior alveolar height, ramus height (AR-Go), lower posterior alveolar height, PP-MP angle and upper posterior facial height (SE-PNS) in open bite.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.3
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• pp.165-167
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• 2015

It has recently been reported that long-standing post-traumatic open bite can be successfully corrected with botulinum toxin type A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM). The report documented an individual with bilaterally symmetrical and otherwise unremarkable anterior digastric musculature. However, the existence of variant anterior digastric musculature is common and may complicate the management of anterior open bite with BTX-A injection. Screening for variant ABDM can be accomplished via ultrasound, computed tomography, and magnetic resonance imaging. Screening for variant ABDM should be performed prior to BTX-A injection in order to account for musculature that may exert undesired forces, such as inferolateral deviation, on the anterior mandible in patients with anterior open bite.