Treatment modalities for Anterior Open Bite: a Systematic Review

Anterior open bite (AOB) is a very common malocclusion in the orthodontic practice. The management of this malocclusion is not easy because of its multifactorial etiology; indeed, there are many factors which determines its etiology: oral habits, alterated labial postures, tongue habits and a vertical facial growth pattern. The aim of this study was to analyze clinical features and the different treatments associated to AOB. Patients with AOB show the main clinical and cephalometric features: increase of anterior facial height, with a dolichofacial morphology; supra eruption of the posterior teeth or infra eruption of the anterior teeth; low position of the tongue on the floor of the mouth; increase of plane occlusal, mandibular and gonial angle; counterclockwise rotation of the mandible. The treatment of AOB is complex and it should be carried out in mixed dentition, to avoid resorting to surgery when the patient will be adult. The first therapeutic option consists in the removal of the habit with behavior-modification technique; if necessary, can be used a removable functional appliance with a vertical crib or tongue spurs. However, if the open bite is a result of a skeletal discrepancy, such as supraeruption of the posterior teeth or infraeruption of the anterior teeth, spontaneous correction might not occur. In this case, it is necessary to redirect maxillary growth with molar intrusion, to rotate the mandible in an upward and forward direction. The literature confirms that there are several ways to obtain these results.