Case Description

Category

Orthodontics

Case Description

The patient presented with a pronounced skeletal open bite anomaly, dental crowding, and a crossbite. He had previously visited multiple clinics, where orthognathic jaw surgery was the only treatment option offered.

Before the advent of bone anchorage systems (mini-implants, TADs), such cases could only be managed through orthognathic surgery. As this is a major procedure performed under general anesthesia and carries inherent risks, patients frequently seek less invasive alternatives.

Through skilled application of fixed orthodontic biomechanics and skeletal anchorage, this case illustrates how intrusion of the posterior teeth into the bone can be utilized to correct a skeletal open bite.

The stability of results achieved by this method is equivalent to that of orthognathic surgery. Other methods for treating such anomalies tend to be significantly less stable. While the process is demanding for both the orthodontist and the patient, it is viable with determination and discipline.

In this case, the patient adapted well to all intraoral components of the treatment. His motivation increased steadily as he observed notable progress at each follow-up visit. The overall treatment duration was three years.

The success of the orthodontic therapy is evidenced by the superimposition of lateral cephalometric radiographs taken at the beginning and end of the treatment, clearly demonstrating the upward movement (intrusion) of the upper posterior teeth—one of the most challenging movements in orthodontics.

At the conclusion of therapy, all six of Andrews’ keys to normal occlusion were met, which we always emphasize due to their critical role in long-term stability, oral health, and ideal masticatory function. These include alignment of the upper and lower dental midlines, placement of the upper canines behind the lower canines in Class I occlusion, upper incisors overlapping the lower incisors by the ideal vertical height of 2 to 3 millimeters with a gentle curve of Spee, correct axial inclinations of the teeth, absence of rotations, and no interdental spacing.

Through critical and meticulous application of the latest knowledge and innovations, we continue to deliver the best solutions for complex cases, consistently pushing the boundaries of orthodontic therapy.