Orthotown July-August 2023 - 18
MESSAGE BOARD 1
Posterior Open Bite Problems
Townies help root out (and rule out) the cause of a doc's problematic pattern
Darth Kenobi
Post: 1 of 10
5/10/2023
Hello, everyone. As of late, I have been running into bilateral posterior open bites in my office. I was curious if
any of the old-timers had any advice on dealing with this, and also the typical etiology. (When I say " posterior open
bites, " I am not including those caused by tongue thrusts or habits. I would also rule out ankylosed molars as a possible
cause. In addition, I would not include the common side short-term effect from aligner treatment.)
Is it typically a CR-CO shift? Is it caused by a skeletal issue typically? I've tried taking off the appliances and hoping
for some " magical " settling, but that does not seem to happen.
Also, other than having the patient wear posterior vertical elastics, are there any other tricks for dealing with
this? Thanks. n
Dr-T
Post: 2 of 10
5/10/2023
At first, I thought you meant you were seeing an increase in posterior open bites on new-patient exams, but it
sounds like you are talking about active treatment patients.
In that case, it is likely related to the mechanics being used. Can you describe the types of appliances, elastics,
wires and any other devices being used on these patients? Are they Class 2 or 3 patients? My thought is some type of
anterior repositioning of the condyles is occurring, possibly from strong Class 2 elastics. n
fesdds
Post: 3 of 10
5/11/2023
My thought without seeing details is that flaring of lower incisors causes premature contacts on the anteriors,
which causes posterior open bite. n
Fenrisúlfr
Post: 4 of 10
I'd check anterior torque first and adjust with IPR or exos if needed. n
5/11/2023
Darth Kenobi
Post: 5 of 10
5/12/2023
It seems to affect both Class 2 and Class 3 patients. These open bites are too far for crowns, step-bends or occlusal
adjustments. Also, orthognathic surgery is typically a nonstarter. Thank you for the advice thus far. n
JULY/AUGUST 2023 | 18 | ORTHOTOWN.COM
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Orthotown July-August 2023
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