When associated with anterior open bite, Class II malocclusions have proven to be a daunting challenge for orthodontists. Aligner systems now seem to be able to treat various types of malocclusions, and in recent years, many studies have demonstrated their efficacy in correcting crowding, misalignment and diastemas, and even complex cases involving open bite and poor occlusal relationships.
The present case report describes the management of Class II malocclusion and open bite in a growing patient using the Invisalign Teen system (Align Technology, San Jose, CA, USA). A specific protocol was followed during treatment planning: transverse expansion, control of the vertical dimension, and sagittal correction using Class II elastics.
Clear aligners proved to be highly effective in the resolution of Class II malocclusion and open bite, inducing molar intrusion and repositioning of the mandible.
Introduction
Class II malocclusion can be due to skeletal or dental maxillary protrusion, mandibular retrusion, or a combination of factors1-3. When associated with anterior open bite, Class II malocclusions have proven to be a daunting challenge for orthodontists. Several aetiological factors are involved in this type of malocclusion, such as facial growth pattern, sucking habits, tongue thrusting, mouth breathing and postural mandibular imbalance.
Other factors like severity and time of initial treatment can make management of Class II malocclusion with open bite correction and stability more difficult to achieve4.
Recent systematic reviews and meta-analyses have shown that treatment of Class II malocclusion produces greater skeletal mandibular effects when performed during puberty (CS3 according to the cervical vertebral method [CVM])5-7. An effective and universally accepted treatment strategy for this type of malocclusion in growing patients involves promoting mesial repositioning of the mandible to correct the Class II dentoskeletal relationship8; maxillary expansion is performed initially to facilitate functional mandibular advancement and posterior intrusion to rotate the mandible upwards and forwards with control of oral habits, which helps to resolve open bite.
Aligner systems now seem to be able to treat various types of malocclusions, and in recent years, many studies have shown their high level of efficacy in correcting crowding, misalignment and diastemas, and even complex cases involving open bite and poor occlusal relationships9-13.
The use of elastics to correct Class II malocclusion can be reasonably effective with clear aligner treatment in growing patients that are fully compliant in wearing the elastics as directed by the orthodontist.
The present case report discusses the management of Class II malocclusion and open bite in a growing patient using the Invisalign Teen system (Align Technology, San Jose, CA, USA).
