Vertical anterior relapse

Cephalometric evaluation of anterior open-bite nonextraction treatment, using multiloop edgewise archwire therapy

“…The extrusion of the maxillary second molars and the entire mandibular posterior teeth during treatment could have brought about this mandibular rotation, as supported by previous studies. 1,5,6,[10][11][12]31,32,35 This mandibular rotation was an unfavorable change for openbite correction because of the decrease in the original overbite and the increase in the anterior facial height. It was confirmed in the present study that the smaller the extrusion of the maxillary right first and second premolars and the mandibular right first molars, the greater was the open-56 bite correction.…”

“…[11][12][13][14] Etiological factors are said to include digit-sucking habits, 1-3 orofacial muscle activity, 2-9 lymphatic tissue, 1,2,4,6 unfavorable growth patterns of the maxilla and mandible, 5,6,10-11 and heredity. 3,5 Previous lateral cephalometric studies have shown that skeletal open-bite malocclusions are generally characterized by a steep mandibular plane, 1,5,7,[12][13][14][15][16][17] an obtuse gonial angle, 1,5,14,16 an anteriorly upward-tipped palatal plane, 5,12,14-16 a long lower anterior facial height, 1,5,12,15-17 a short (lower) posterior facial height, 1,5,14,16,17 a retrusive mandible, 1,12,14 proclined and/or protruded maxillary incisors 1,12-14 and mandibular incisors, 1,5,7,12,14 and extruded maxillary incisors 1,5,12,17 and molars.…”

“…Treatment of anterior open bites is regarded as one of the most challenging areas in orthodontics, as malocclusions of this type develop due to the interaction of various etiological factors [1][2][3][4][5][6][7][8][9][10][11] and have strong relapse tendencies. [11][12][13][14] Etiological factors are said to include digit-sucking habits, 1-3 orofacial muscle activity, 2-9 lymphatic tissue, 1,2,4,6 unfavorable growth patterns of the maxilla and mandible, 5,6,10-11 and heredity.…”

Biomechanical Factors in Surgical Orthodontics

“…12,13 When significantly different anterior and posterior occlusal planes are present, the treatment occlusal plane must be chosen prior to initiating surgical orthodontic treatment. The discrepant occlusal planes can be managed orthodontically or surgically, and the decision regarding which method is better is largely philosophical and based on the stability of the surgical intervention versus the stability of the vertical orthodontic movement.…”

“…12 Now, with rigid fixation, less immediate postsurgical relapse occurs, and the mandible does not need to be placed in an edge-to-edge "tripod" occlusion, but merely into Class I with a mid arch open bite. An extremely efficient way to obtain leveling is to perform the mandibular advancement surgery early in treatment prior to leveling the curve of Spee.…”