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Anterior Open Bite Closure Followed by Porcelain Restorations for Superior Esthetics

by Dr. Michelle Hedgecock, on 9/25/18 3:15 PM

Case Review by Dr. Michelle Hedgecock

Patient Info:
32 years old, Female.

Patient’s Chief Complaint: Undersized maxillary laterals, flared upper and lower incisors and lower crowding. Patient also did not like the anterior open bite.

Assessment & Evaluation Prior to Treatment: Patient had orthodontics in high school and she still had an upper lingual bar in place. She reported that the anterior open bite was not present after her braces were removed and that it has progressively worsened over the years. Any time we have a patient who has had previous orthodontics and presents with an open bite we must determine the etiology of the open bite. We evaluate the shape of the maxilla to rule out any airway issues.

If a V Shaped maxilla and vaulted palate are present the patient will be sent for a sleep study to rule out sleep apnea. If the patient does have sleep apnea, we know that we have to treat the airway with either a CPAP or Dental Sleep Appliance after orthodontics to prevent relapse. We also check for a tongue thrust by retracting the cheeks, having the patient bite together and swallow. If the tongue protrudes through the anterior teeth upon swallowing, then we know that the pressure from the tongue during swallowing has caused the relapse. At this point we refer the patient to a speech pathologist for myofunctional therapy, which can be completed concomitantly with ortho.

Treatment: Standard bracket placement and Six Month Smiles protocol utilized with the goals of closing the anterior open bite and aligning the gingival margins in the maxillary anterior for superior final esthetics. To close the open bite the patient wore canine elastics throughout treatment.

Conservative adhesive porcelain restorations were fabricated #7-10 and dual retention (bonded and removable retainers) is being utilized.

Final Restoration


About the author:

Dr. Michelle Hedgecock
Dr. Michelle Hedgecock
Dr. Hedgecock was born in Houston and grew up in the very small town of Danbury, Texas. She attended Texas A&M University, where she studied biomedical science and minored in business. During her junior year at A&M, Dr. Michelle was accepted early into dental school, where she graduated magna cum laude. She received the Award for... read more →


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