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

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.