Nonsurgical orthodontic treatment for an adult with skeletal open bite, class III malocclusion and posterior crossbite: A case report

Abstract

Class III malocclusion associated with skeletal anterioropen bite pattern in adults can be a challenging orthodontic problem, especiallyfor the nonsurgical treatment. Conventionally, several treatment alternativesare available such as tooth extraction, molar intrusion, and absolute anchoragesystem or orthognathic surgical correction. Although correction with surgerymay be the most effective and stable way, many patients refused surgicaltreatment plan because of the costs and traumas it may bring. We reported anonsurgical orthopedic treatment of 22-year-old male with severe skeletal anterioropen bite, dental Class III malocclusion, posterior crossbite and a highmandibular plane angle. The patient refused surgery and extraction. So we formulateda treatment plan consisting of using rapid palatal expansion appliance toexpand the maxilla, standard edgewise brackets to align the teeth, Class IIIelastics to correct the canines, premolars, and molars relationship, reversecurve of the nickel-titanium wire combined with anterior vertical elastics tointrude molars and correct open bite. In this case, without suffering of surgery, the posterior crossbite was ideally corrected, and ideal overjet andoverbite relationships and functional occlusion were all achieved. Thepatient obtained satisfactory occlusal as well as functional and stableresults.