Ortho Management of Adult Anterior Open-bite Part 2

222 Rating(s).

Posted on By Maurice Salama In Orthodontics

Patient presents with Class 2 bi-maxillary protrusion, anterior open-bite and tongue thrust. Some perio issues remain. Patient told by other dentist to have all maxillary teeth removed and full arch implants performed to replace her teeth in correct and esthetic positions. 2 Maxillary Premolars and 1 mandibular central incisor extracted to allow for retraction and closure of Open-Bite non-surgically. Thoughts on treatment and long term retention? regards Dr. Salama

Ortho Treatment
Lateral View after ortho

Frontal view after ortho
Smile View

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See Related posts top Right of Screen for Part 1. Dr. Salama


Very nice Maurice !! Would you consider neck lipectomy ? Would make her face better. Retention for me is a fixed lower retainer and in the upper a circumferential with a tongue crib for night wear and a invisible retainer for day wear. Miguel


Completely agree....Miguel


Life changing treatment. Wow Maurice you gave back to this patient way more than just a beatiful smile.



Thank you Yiannis. I do believe still in perio-ortho treatments and preserving the natural dentition whenever possible and patient is motivated. regards Maurice


Mo. Outstanding result from a relatively conservative and non invaisive treatment. I am glad this patient didn't submit to the "If you only have a hammer everything looks like a nail" mentality and loose all of her teeth. It is fortunate this patient explored her options and luckily found a knowledgable and skilled practitioner such as yourself. Congratulations to both of you. Thank you for sharing. Best regards. Chuck


Nice results,the patient looks great. The patient appears to still have a mentalis habit to account for the closure of the lip incompetence. I would really like to see a new ceph. I am having a hard time understanding how retraction of the anterior segments allowed for closure of the lip incompetence which is due to posterior vertical dimension, which was not changed? There would be some increased lip length from the retraction of the maxillary anterior but the class 2 profile would be made worse from the retraction of the lmandibular anterior segment.


Pre and Post Cephalometric images for review. Non-surgical therapy. Ortho alone now one year out of treatment and in retention. Dr. Salama

Ceph Preop
Ceph Post-op


Awesome case Maurice. Loved the conservatism,and the outcome . Thanks for sharing.


Preop and Post op Smile...



Hi Maurice;
Spectacular results.
I am thrilled that you did not listen to those that thought that full maxillary extractions and implants were the correct treatment.
Wait till all the zirconia starts to fail or the implants fail...Dentists will say what they always say:"We didn't know."


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