Posterior impaction with orthodontic miniscrews for openbite closure and improvement of facial profile

Neal D Kravitz, Budi Kusnoto
World Journal of Orthodontics 2007, 8 (2): 157-66
Skeletal anterior open bite is often caused by posterior dentoalveolar excess and downward and backward mandibular rotation. Orthodontic miniscrews can successfully impact the posterior dentition, allowing for open-bite correction through upward and forward mandibular autorotation. An Asian male, 27 years of age, with a Class II skeletal relationship, dolichocephalic facial type, high mandibular plane angle, 4.0-mm anterior open bite, and convex soft-tissue profile was treated with 4 dentoalveolar orthodontic miniscrews. The maxillary first and second molars were impacted 1.4 mm, resulting in open-bite closure, 2. 1 degrees of upward and forward mandibular autorotation, 2.0-mm advancement of pogonion, 3.5-degree reduction in soft-tissue facial convexity, and 2.6-mm increase in anteroposterior pharyngeal dimension on the lateral cephalogram. This case report demonstrates successful treatment with orthodontic miniscrews in open-bite closure with Class II correction, without extraction or surgically positioned miniplates. Miniscrew-supported posterior impaction and mandibular autorotation may become a viable treatment alternative to surgery in patients desiring improvement in their excessive dentofacial vertical dimension and facial esthetics.

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