A Novel Approach for Anterior Open bite Correction
Clinical Pearl
1Lijo K Jose, 2Muhammed Raheesh P, 3Varun Peter, 4Sajitha K B, 5Divya Babuji
To cite: Lijo K Jose,
1Professor, 2,4,5PG student, 3Senior lecturer
Muhammed Raheesh P,
Varun Peter, Sajitha K B,
1-5 Department of orthodontics and dentofacial orthopedics, PSM college dental science and research
Divya Babuji
Akkikavu.PO, Thrissur , Kerala.
A novel approach for
Anterior Open bite
Over the years, several methods have evolved for correction of open bite. Open bite correction
using elastics in clinical situation have always been a matter of concern for patient as well as
J Contemp Orthod 2020;4(4):
clinician. This articles aims to explain an auxillary arch wire for closure of openbite with minimal
Received on:
patient compliance.
Accepted on:
Keywords: Openbite, Extrusion, Auxillary Archwire
Source of Support: Nil
Conflict of Interest: None
Openbiteis a malocclusion in which the maxillary and
Steps in fabrication :
mandibular teeth are vertically apart without interdigitation of
Alginate impression of upper and lower arch was made.
The etiological causes of openbite are
The dental cast are then prepared.
multifactorial.1Treatment for open bite involve various
A 17x25 continuous stainless steel wire is used for
approaches, which includevertical facial height reduction with
fabrication of auxillary arch wire.
surgery in long-face skeletal problem or intrusion of molars,
Design -The appliance design is influenced by
local causes by tongue are corrected by use of cribs, rake or
Rickett’s utility arch3 and Burstone’s continuous arch4.
tongue reduction surgery. Functional appliance shields are
(fig - 1)
used for open bite caused by facial musculature pressure.
Dental correction is achieved by use of elastics, which
a. Starting from the molar segment, a
90 degree
requires patient compliance and affects the comfort and
vertical bend is placedmesial to buccal tube of
esthetics of the patient2.
molars,a helix is incorporated in theappliance.
This article explains about an auxillary arch wire for
b. After completing one turn of helix, the wire is
correction of dental openbite without the need for patient
contoured along the vestibule of the patient till distal
of lateral incisor bracket.
c. A
90 degree bent is placed towards the lateral
incisor bracket to form anterior vertical arm which
A 23 year old male patient reported with the chief complaint
again take a right angle to enter lateral and central
of gap in front teeth in both upper and lower arches and lack
incisor brackets(incisal segment) and form a mirror
of contact between the arches in the front region. On
image on opposite side.
examination, patient was found to present with Angles class I
d. The appliance is activated by closing the helix,
molar relation with anterior open bite, convex profile and
which displaces the incisal segment more incisal to
tongue thrusting habit.
bracket, thus producing an extrusive force
engagement) on anterior teeth to close the openbite.
Treatment plan included fixed tongue crib for correction of
habit, fixed orthodontic therapy for alignment and space
closure, followed by auxillary arch wire in upper and lower
arch for correction of openbite.
Fig 1 - Appliance in position
The auxillary arch wire method to correct anterior open bite is
an easy chair side wire bending technique,highly accepted by
patients. Patients do not have to change elastics daily nor any
esthetic problems arise. Use of sleeves can be appreciated in
vestibular part to avoid tissue irritation.
Fig 2 - post open bite correction
Subtelny J D, sukada M, Open-bite: Diagnosis and
treatment.Am. J. Orthodontics, 1964;50(5):337-358.
Isaacson R J and Lindauer S J, Closing Anterior Open
Bites: The Extrusion Arch. Seminars in Orthodontics,
2001;7(1) :34-41.
Bench RW, Gugino CF, Hilgers JJ. Bioprogressive
Therapy, Part Vll: The utility and sectional arches in
bioprogressive therapy mechanics. J ClinOrthod
Burstone CD. Deep overbite correction by intrusion. Am
J Orthod 1977;72:1-22.
Journal of Contemporary Orthodontics, Oct-Dec 2020;4(4):44-45