Good morning everyone. Today I am writing a post about a complex open bite case I resolved at my practice following my own protocols.
As you can see in the first photographs, the open bite the patient had caused problems with tooth wear and gum recession in the side sections. That was what made it urgent to resolve the case.
The patient had already been to other practices, but he was not convinced by the options he had been offered. He had been told that his case had to go through orthognathic surgery and that a tooth extraction would probably be needed too. That had held him back from deciding to go ahead with treatment. Through an acquaintance he heard about the real experience of Peydro patients and, once he knew how we worked, he came to see us.
After a thorough study of the case we drew up a treatment plan in which we would work with Invisalign aligners alone. We were able to reassure the patient that our deep knowledge of the technique would deliver excellent results in his mouth, however complex his problem was. And of course we would achieve all of that without tooth extractions and without resorting to surgery.
One of the challenges I set myself in this case was that the patient had what was almost an anterior gummy smile. The challenge here was to close the complex open bite without making the smile line worse and without increasing the gummy smile. To do that, the work I planned was to develop the arches transversely. I had to design parabolic, round, wide arches for the patient, coordinated in the upper and lower jaw, so that this work on width, this transverse work, would allow the lower jaw to rotate forward. That forward rotation would let us close the open bite. In this way we would keep the good position and relationship of the upper incisor with the lip.
The case was resolved with 24 months of treatment using Invisalign aligners alone, and in the later stages micro-screws were placed in the back sections that helped us intrude the molars, or move them vertically, to help close the open bite. As you can see, the result at the bite level is wonderful and we finished with a perfect bite and a perfectly closed open bite. What matters most for the patient is that we achieved a perfect bite, perfect jaw function and a very beautiful smile.
