Correction of Skeletal Openbite Using Zygomatic Miniplates

Abstract

Aims: Anterior open bite is often caused by excessive vertical development of the  posterior maxilla. In such cases, it is hardly possible to establish absolute anchorage for molar intrusion by traditional orthodontic mechanics. The use of skeletal anchorage for orthodontic tooth movement is offering a minimally invasive treatment option for correction of skeletal anterior open bite and enhancement of facial esthetics as an alternative to major surgery. Presentation of Case: This article reports a case of 23 year old female patient, who had a moderately severe skeletal anterior open bite, that was successfully corrected by using titanium miniplates and miniscrews. The miniplate were inserted in zygomaticomaxillary buttress area and fixed with two miniscrews on each side. Titanium miniscrews were inserted bilaterally in palatal region to preserve molar axial inclination during intrusion. An intrusion force was provided with niti coilsprings for 9 months. Discussion: After active treatment of 24 months, The mean amount of accomplished molar intrusion was 2.8 mm ± 0.64 mm, with a rate of 0.311 mm ± 0.071 mm per month and a bite closure of 5.61 mm ± 1.23 mm. No significant buccal tip was observed in the right and left molars upon intrusion. Her retrognathic chin and convex profiles were improved by counterclockwise rotation of the mandible. Conclusion: Our results suggest that titanium miniplates are useful for intrusion of posterior teeth. Intrusion of the posterior teeth induced counterclockwise rotation of the mandible and, as a consequence, corrected the anteroposterior intermaxillary relationship with a significant improvement in the facial soft tissue convexity.