Abstract

Objective: High-angle cases frequently show a vertical growth pattern, high mandibular plane angle and a long lower facial height. Such cases are referred to as skeletal open bite, and are most difficult to treat orthodontically, they may require skeletal anchorage or surgery. The aim of this case report is to highlight the importance of miniscrews in a severe open bite case.

Method: Patient presenting with anterior and lateral open bite, long face syndrome, respiratory problems (13 years 2 months) admitted to the clinic for orthodontic evaluation. She had severe crowding, cl II skeletal relationship, proclaimed incisor, anterior and lateral open bite and gummy smile. Patient was informed about surgery, but she refused. At the beginning of the treatment leveling was carried out with extraction of four first premolars. After one appointment of applying the stabilization arc wire (17x25 SS) 4 miniscrews (2 for buccal, 2 for palatal side) was used for intrusion of maxillary molars. Also 1 miniscrew was inserted between 11-21 for controlling the elongation of incisors because of gummy smile.

Result: After six months of intrusion molars, mandibular autorotation was achieved. Leveling and alignment was completed. Class I molar and canine relationship were achieved. Although we used full arch wire intrusion mechanics, gummy smile didn’t get worse. Profile was improved.

Conclusion: Miniscrews are very important in orthodontic treatment for patients who refuse to have surgery. Although we obtain more aesthetic results in surgery, also miniscrews might be used for the comprehensive treatment.

Keywords: Open bite; Skeletal class II; Orthodontic treatment; Miniscrew