Closure of severe skeletal anterior open bite with zygomatic anchorage

An open bite is commonly one of the main symptoms of an overall dentofacial deformity. Most anterior open-bite cases are characterized by excessive vertical development of the posterior maxilla. Intrusion of the overerupted molar teeth by traditional orthodontic methods is hardly possible; there is therefore no real alternative to a combined orthodontic and surgical approach. Skeletal anchorage has recently been proposed for the orthodontic movement of teeth. Titanium miniplates implanted in the zygomatic buttress area can serve as the absolute anchorage for maxillary molar intrusion. The aim of this study was to evaluate the use of skeletal anchorage for the closing of open-bite malocclusions. Seven patients with severe anterior open bites were selected, in all of whom the deformity was due to overeruption of the maxillary molars. Titanium miniplates were inserted bilaterally in the zygomatic buttress region and fixed with miniscrews. Elastic bands or coil springs were used to reduce excessive maxillary molar heights. In all cases, the anterior open bite improved significantly. The mean duration of active treatment was 6 months. No significant side effects were observed. Our results show that skeletal anterior open bites due to posterior maxillary dentoalveolar hyperplasia can be closed with intrusion of the upper molar teeth. This method is a safe, quick, and less expensive alternative to orthognathic surgery.