Decision making in borderline open bite cases: Surgery or no surgery? A case report

In open bite cases, comprehensive diagnostic differentiation is crucial to determine the best form of corrective therapy. In adult patients, treatment options are limited to orthognathic surgery (for patients with unaesthetic facial proportions) or less invasive treatment solutions (fixed appliances or clear aligners). The present case report outlines the treatment of a 30-year-old man with skeletal Class I malocclusion, Class III right subdivision malocclusion, an anterior open bite and the presence of a supernumerary mandibular incisor. The particularity of this case was the fact that it was referred directly to the orthodontist by the maxillofacial surgeon for a surgical-orthodontic protocol with maxillomandibular osteotomy, but from the start, the patient admitted that he no longer wanted to undergo the surgery. The treatment plan consisted of extracting the supernumerary incisor, correcting the Class III malocclusion, closing the open bite with clear aligners and providing speech therapy. After 13 months of treatment, the open bite was reduced significantly and the patient was extremely satisfied. Keywords: adult orthodontics, AirNivol, anterior open bite, clear aligners, speech therapy