Anterior open bite is one of the most challenging cases to treat via either camouflage or orthognathic surgery. This type of malocclusion is commonly developed from skeletal dysplasia or various oral habits. It can also be associated with degenerative joint disease in temporomandibular joints (TMJ), which results in condylar erosion and leads to this occlusal disharmony. Proper management of oral habits and temporomandibular disorders (TMD) is the major issue to treat the associated anterior open bite successfully. This report presents a growing patient with anterior open bite malocclusion associated with TMD which was treated by medication, splint therapy and orthodontic treatment.
Class I malocclusion with anterior open bite on skeletal Class II base with average mandibular plane angle
This was a 15-year-old female revealing anterior open bite. She illustrated bilateral dull pain over the pre-auricular region and crepitus sound over her TM joint. Radiographic image presented with irregular and erosive TMJ. After TMD was well-controlled by medication and splint therapy, the orthodontic treatment including the extraction of the 2ndpremolars was planned. The treatment took 3.5 years to achieve proper overbite, overjet, and stable occlusion.
To treat the anterior open bite successfully, the appropriate management of etiologic factors including the adverse oral habits and the active degenerative joint disease is essential. It may include training of tongue posture and apply splint therapy in this patient. The subsequent orthodontic treatment was aimed at gaining the stable occlusion and the result was desirable.