Front Teeth Open Bites-An Orthodontic Treatment Paradigm shift

Tuesday, 05 Nov 2019 Andrew Chang 164 hits Print it

Front Teeth Open Bites- A Orthodontic Treatment Paradigm shift that Benefits Adults and Teens

Below is an adaptation of an excerpt of a presentation I gave to a large group of dentists recently, informing them of better and safer ways to straighten teeth with front teeth open bites.

An Open bite is where the front teeth do not meet. Causes of open bites can be due to the jaw structure, fingersucking or nailbiting and tongue habits.

Open bites can lead to lisps when speaking, where the “th” and “s” sounds can appear to sound mispronounced despite one’s best efforts .

Front Teeth Open Bites-1

There are many teen and adult patients with moderate to severe front teeth open bites that would once have needed jaw surgery to correct. This would also have meant delaying treatment in teens till growth is complete, which would allow soft tissue habits ie: tongue posture/thrust/lip sucking to be more ingrained and difficult to correct.  Orthodontic treatment for this group has evolved to be less complex and more comfortable for patients, all without requiring jaw surgery. Jaw surgery is not without significant complications, and this may not suit many teens or adults. 

This new paradigm involves the use of temporary anchorage microscrews (TADs). Usually made of stainless steel or titanium, these are placed into the gum, to assist with teeth movements, with upper and lower braces. Placed under local anaesthetic, there are significantly less risks with TADs compared with jaw surgery. The 2 examples below illustrate the excellent outcomes that can be obtained.

Front Teeth Open Bites-2

Front Teeth Open Bites-3

The disadvantage of braces is most mechanics, if not properly thought of, are extrusive in nature ie: counter to what would help to correct this.  The emergence of clear removable aligners ie: Invisalign, Spark, Suresmile, Signature Aligners etc has made anterior open correction without TADs more predictable and comfortable for patients. 

This adult below illustrates how clear removable aligners can be used to quickly obtain front teeth open bite closure. All wisdom teeth, as they were fully grown, were retained. No temporary anchorage microscrews (TADs) were used. The front teeth open bite was corrected in 8 months. 

Front Teeth Open Bites-4

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