PMC5952238_01
Pretreatment photographs
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F1
An anterior open-bite extended from first molar to first molar [Figures 1 and 2].
Pretreatment dental casts
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F2
An anterior open-bite extended from first molar to first molar [Figures 1 and 2]. Only the second and third molars were in occlusal contact [Figures 2 and 3].
Pretreatment radiographs. (a) Lateral cephalometric; (b) Panoramic
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F3
Only the second and third molars were in occlusal contact [Figures 2 and 3].
Miniscrews placed and biomechanics employed for molar intrusion
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F4
Short elastic chain [3M Unitek, Monrovia, Calif, USA] was used to apply the intrusion [Figure 4] during the middle of which, the left buccal miniscrew needed to be repositioned more apically, because it approached the molars.
Open bite reduction during active phase of orthodontic treatment. (a) After 20 months of treatment (16 months of intrusion) was verified a considerably open-bite closure and the use of vertical intermaxillary elastics were initiated and; (b) Effect of vertical intermaxillary elastics after 12 months of use, closing the open bite
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F5
Figure 5a shows the elastic chain in the mandibular arch, and the anterior teeth tied-together in the maxillary arch to avoid reopening of the spaces. After 20 months of treatment, considerable reduction of the open-bite had occurred [Figure 5a]. At this time, 0.018-inch stainless steel arch wires were inserted in the maxillary and mandibular arches, and bilateral vertical interarch elastics were added to aid in the closure of the remaining open-bite [Figure 5b]. The vertical elastics were used 20 h/day for 12 months and the results can be observed in Figure 5b (open-bite closure).
Retainers used after active phase of orthodontic treatment. (a) Two retainers with posterior bite blocks were constructed; (b) Daytime retainer with an orifice close to the incisive papillae and; (c) Night-time retainer with a palatal crib
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F6
Two maxillary appliances with posterior bite blocks to retain the posterior intrusion were constructed for day and night-time use [Figure 6a]. The daytime retainer incorporated an orifice close to the incisive papillae which guided correct tongue position [Figure 6b]. The night-time retainer contained a palatal crib to prevent lingual pressure on the anterior teeth [Figure 6c].
Posttreatment photographs
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F7
A loop was made in the mandibular retention wire to allow subsequent restoration of the left central incisor [Figure 7].
Posttreatment dental casts
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F8
Posttreatment lateral cephalometric radiograph
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F9
Three years posttreatment photographs
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F10
The patient was satisfied with the treatment results, and the outcome was stable 3 years after the end of active treatment [Figures 10 and 11]. Therefore, a 0.020-inch stainless steel wire was bonded to the palatal surfaces of these teeth [Figure 10].
Three years posttreatment radiograph. (a) Lateral cephalometricand; (b) Panoramic
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F11
The patient was satisfied with the treatment results, and the outcome was stable 3 years after the end of active treatment [Figures 10 and 11].
Cephalometric superimposition
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F12
The dentoskeletal changes that occurred during treatment and after 3 years posttreatment are presented in the cephalometric superimposition [Figure 12].