Journal of Aligner Orthodontics, 03/2023

The approach used to treat open bite depends on the origin of the anomaly and the Angle classification. This vertical deviation can be dental or skeletal in nature, or both combined. If removable appliances, such as an oral vestibular plate, or palatal expansion and myofunctional therapy are used in early treatments, multibracket therapy, extraction therapy or orthodontic treatment in combination with surgery are most used in the permanent dentition. Aligner therapy offers a valuable alternative approach for treating dentoalveolar open bite, and its use in combination with skeletal anchorage broadens the spectrum of orthodontics even more. The present article shows different examples of open bite patients treated with aligner orthodontics alone and discusses the incorporation of virtual articulators in treatment planning. Keywords: aligner orthodontics, attachments, Dental Motion Decoder-System software, extrusion, in-office aligners, interdisciplinary dentistry, intrusion, Invisalign, OnyxCeph Aligner 3D software, open bite, virtual articulator

The present case report describes the treatment of a 25-year-old woman using clear aligners to correct midline deviation and molar tipping caused by tooth loss. The patient’s maxillary left second premolar and mandibular right first molar had been missing for approximately 10 years without having been restored, and the teeth next to the edentulous space were tipped and rotated. She presented with a Class II malocclusion on both sides, with a Class II canine relationship on the right and a Class I canine relationship on the left. The maxillary midline deviated 1.5 mm to the left and the mandibular midline deviated 2.0 mm to the right, giving a total midline discrepancy of 3.5 mm. The treatment involved extraction of the maxillary right second premolar, distalisation of the mandibular left molars, interproximal reduction of the mandibular left anterior teeth and mesialisation of the mandibular right second molar. During treatment, a power arm bent with 19 to 25 mm stainless steel wire was used with maxillomandibular elastics to upright the second molar. After 35 months of active treatment, a full-cusp Class II molar relationship and Class I canine relationship were obtained, and the maxillary and mandibular midlines were consistent with the facial midline. This case report demonstrates that clear aligners can be used to correct more complex cases of malocclusion. Keywords: adult orthodontics, Class II malocclusion, clear aligners, mesialisation, molar distalisation, molar uprighting

In open bite cases, comprehensive diagnostic differentiation is crucial to determine the best form of corrective therapy. In adult patients, treatment options are limited to orthognathic surgery (for patients with unaesthetic facial proportions) or less invasive treatment solutions (fixed appliances or clear aligners). The present case report outlines the treatment of a 30-year-old man with skeletal Class I malocclusion, Class III right subdivision malocclusion, an anterior open bite and the presence of a supernumerary mandibular incisor. The particularity of this case was the fact that it was referred directly to the orthodontist by the maxillofacial surgeon for a surgical-orthodontic protocol with maxillomandibular osteotomy, but from the start, the patient admitted that he no longer wanted to undergo the surgery. The treatment plan consisted of extracting the supernumerary incisor, correcting the Class III malocclusion, closing the open bite with clear aligners and providing speech therapy. After 13 months of treatment, the open bite was reduced significantly and the patient was extremely satisfied. Keywords: adult orthodontics, AirNivol, anterior open bite, clear aligners, speech therapy

At the turn of the millennium, aligners came onto the market as a new treatment method in orthodontics. Now, aligner therapy is used worldwide. How do our readers view aligner orthodontics today? The JAO decided to ask them. In this issue, we speak to our colleague Dr Akim Benattia of the La Marsa private practice in Carthage, Tunisia.

The following amendments are made to the published article: J Aligner Orthod 2023;7(2): 113–127; First published 3 July 2023