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Abstract

Anterior open bite is a common and challengeable malocclusion. To manage Angle Class I molar relationship in adult cases with several problems, such as high mandibular plane angle, maxillary canting, anterior open bite, discrepancy of anterior Bolton ratio and bilateral posterior crossbite, we should choose therapeutic method carefully. It is not necessary to improve occlusion and profile with orthognathic surgery. A case of an adult woman with tongue thrust had the chief complaint of anterior open bite. The principle of orthodontic treatment without orthognathic surgery is the occlusal plane change and vertical control to achieve the forward rotation of mandible and the closure of anterior open bite at the same time. The transpalatal arch was used to enforce vertical control, and tongue crib was applied to inhibit tongue thrust and improve bilateral cross bite with dental compensation. Progressively, Chewies (Chewies™, Aligner Tray Seater, DENTSPLY International, USA ) exercise was applied to keep vertical control and train muscular activity with positive cooperation. Chewies exercise combined with Class III intermaxillary elastics achieves the movements of lower dentition and obtains the similar effect of multiple edgewise arch wire therapy.

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