Anterior Open Bite


Anterior openbite with an increased mandibular plane angle.

Normal or reduced upper incisor display

Class I or mild-moderate skeletal II relationship.


Case Details:

Adult with a Class II division malocclusion (9mm overjet, 7mm AOB), Class II facial profile and all 1st premolars absent.

Declined bimaxillary surgery. Treated by extraction of 8s, fixed appliances, Infinitas palatal anchorage and intrusion TPA.


Key Points:

Requires excellent periodontal status and bonded tubes on terminal molars.

Palatal mini-implants (1.5mm diameter, 9mm length, long neck) inserted U6-7s (or U5-6s if U7s not fully erupted) using a slow speed contra-angle handpiece +/- Infinitas guidance stent.

Rigid intrusion TPA fabricated with 5mm clearance off mid-palate.

Control incisor extrusion with a curve of Spee added to the upper archwire.

Ideally over-correct to create posterior openbites before TPA removal, +/- add further traction from mini-implants to bonded palatal attachments on U6s.

Expect mandibular auto-rotation and chin advancement.