Anterior open bite and overjet treated with camouflage therapy

Camouflage therapy is often the treatment of choice for Class II patients with mild to moderate skeletal discrepancies who seek treatment after growth modification is no longer possible. This case report describes the treatment of a 13.5-year-old girl with an orthognathic profile and a Class II Division 1 malocclusion, who had a thumb-sucking habit from ages 5 to 13. This resulted in an end-on molar relationship, a 2.0-mm anterior open bite, and 8.0 mm of overjet. She had protrusive maxillary incisors, mild anterior maxillary and mandibular crowding, and a 1.0-mm mandibular midline discrepancy. She also had a prominent chin button. After cessation of the habit, a Nance appliance was placed, the maxillary first premolars were extracted, appliances were placed, and orthodontic treatment began. The mandibular arch was leveled and aligned, and the maxillary anterior teeth were retracted in 2 stages to close the extraction sites and establish proper overbite and overjet. The maxillary molars were allowed to slip forward into a functional Class II occlusion, and the midline was corrected with interarch elastics. The final occlusal and esthetic results were stable and quite pleasing.