The Development Of Anterior Open Bite

Anterior open bite can develop as a result of genetic and/or environmental factors. Environmental factors include finger and thumb habits (Fig. 6.24), tongue posturing and thrusting problems, and respiratory concerns related to conditions such as allergies, adenoids and tonsils, and mouth breathing.

Genetic factors can contribute to anterior open bite in the following manner. If patients show an excess of anterior vertical facial growth relative to posterior vertical facial growth, they are more prone to anterior open bite. These 'high-angle' cases frequently show a steep mandibular plane angle and a long lower facial height. Such cases are referred to as skeletal open bites, and are most difficult to treat orthodontically, because correction normally requires considerable eruption and torquing of incisors.

On the other hand, if patients have an average or short lower facial height (average- to low-angle cases) (Fig. 6.25), although environmental factors may lead to an anterior open bite, they are usually much easier to treat. Elimination of the causative factors allows rapid bite closure, since significant eruption and torquing of the incisors are not required. Such cases are referred to as dental open biles and can be corrected with little difficulty by eliminating the environmental factors.

Fig. 6.24 This patient had an asymmetrical dental anterior open bite, which was related to right thumb sucking activity. Anterior open bites of this type are often not difficult to correct, provided the digit sucking is discontinued.

Fig. 6.25 The above case showed a near-average vertical skeletal pattern, and the dental open bite was related to thumb sucking. It is normally possible to correct anterior open bites of this type, provided the thumb-sucking activity is discontinued. If the open bite is related to tongue posture, the prognosis for permanent correction is more doubtful.

Fig. 6.25 The above case showed a near-average vertical skeletal pattern, and the dental open bite was related to thumb sucking. It is normally possible to correct anterior open bites of this type, provided the thumb-sucking activity is discontinued. If the open bite is related to tongue posture, the prognosis for permanent correction is more doubtful.

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