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Anterior Open Bite Correction- A
new Standard of Care?
Andrew Chang- Orthodontist
Smiles & Faces Orthodontics, Blacktown. ...
A real challenge
How would these cases have been
treated 5 years ago?
Correct diagnosis important
Rhiann- Before & After Mel- Before
Anterior open bites- The natural
course of growth
Haylee Haylee- after 12 months
AOB: Treat early or Treat late?
Depends on cause
AOB-Dental-Environmental causes
Chloe (12 yr old) Katerina
 1. 21-03-2014.
8 years old
 2. 17-10-2014
(Thumbsuckin
g sto...
AOB-Dental-Environmental causes
Mouthbreathing
Animal Studies- complete nasal
blockage
An overview of Clinical
Evidence
 With regards to % adult size, maxillary growth is mostly complete by 10 years
old.
To significantly affect facial growth...
How to justify to parent all this
spending is worth it?
Parent (thinking aloud): Show me the value proposition!
My story
AOB treated with 4 premolar teeth
extractions-KT
Before After
MI
Before(10 yrs old)
After: wore concurrent HPHG
(upper & lower bondeds placed)
MI
Lost Retainers for 6mths: 1 yr 3
mths post deband 1 yr 9mths post deband
Humbled by skeletal growth & role
of tongue & excessive anterior
extrusion!
A new approach
JB
Before After
JB-Progress
Progress 1
Progress 2: After removal of U bonded
expander. Note vertical position of TAD
HG
Before
Progress-Immediately on removal
of expander
EA
Before
Progress 1
Progress 2: 2 months later
Other Variations (TAD in skeletal
AOB correction)
EL
Before Progress
KB
Before
Progress: OPG and latest
progress photo
She declined jaw surgery (been to 2 consults) and the lower
6’s were sev...
What happened to MI?
Aug 2014 June 2015
Summing it up
What constitutes a better standard of care?
Legal jargon The Golden Rule √
• Operational Risks vrs Benefits?...
The End
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Anterior open bite correction-A new standard of care?

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This is an adaptation of a talk Dr Andrew Chang, principal orthodontist of Smiles & Faces Orthodontics, gave to a group of dentists. We present the case for a safer, predictable treatment alternative to Anterior Open Bite Correction in adults and teenagers, incorporating orthodontic treatment principles and temporary orthodontic micro-implants

Published in: Health & Medicine
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Anterior open bite correction-A new standard of care?

  1. 1. Anterior Open Bite Correction- A new Standard of Care? Andrew Chang- Orthodontist Smiles & Faces Orthodontics, Blacktown. http://www.greatsydneysmiles.com.au
  2. 2. A real challenge
  3. 3. How would these cases have been treated 5 years ago?
  4. 4. Correct diagnosis important Rhiann- Before & After Mel- Before
  5. 5. Anterior open bites- The natural course of growth Haylee Haylee- after 12 months
  6. 6. AOB: Treat early or Treat late? Depends on cause
  7. 7. AOB-Dental-Environmental causes Chloe (12 yr old) Katerina  1. 21-03-2014. 8 years old  2. 17-10-2014 (Thumbsuckin g stopped for 6 months) Thumbsucking habits
  8. 8. AOB-Dental-Environmental causes Mouthbreathing Animal Studies- complete nasal blockage An overview of Clinical Evidence
  9. 9.  With regards to % adult size, maxillary growth is mostly complete by 10 years old. To significantly affect facial growth, therapeutic intervention needs to be really early Scammon’s Growth Curves
  10. 10. How to justify to parent all this spending is worth it? Parent (thinking aloud): Show me the value proposition!
  11. 11. My story
  12. 12. AOB treated with 4 premolar teeth extractions-KT Before After
  13. 13. MI Before(10 yrs old) After: wore concurrent HPHG (upper & lower bondeds placed)
  14. 14. MI Lost Retainers for 6mths: 1 yr 3 mths post deband 1 yr 9mths post deband
  15. 15. Humbled by skeletal growth & role of tongue & excessive anterior extrusion!
  16. 16. A new approach
  17. 17. JB Before After
  18. 18. JB-Progress Progress 1 Progress 2: After removal of U bonded expander. Note vertical position of TAD
  19. 19. HG Before Progress-Immediately on removal of expander
  20. 20. EA Before Progress 1 Progress 2: 2 months later
  21. 21. Other Variations (TAD in skeletal AOB correction)
  22. 22. EL Before Progress
  23. 23. KB Before Progress: OPG and latest progress photo She declined jaw surgery (been to 2 consults) and the lower 6’s were severely compromised.
  24. 24. What happened to MI? Aug 2014 June 2015
  25. 25. Summing it up What constitutes a better standard of care? Legal jargon The Golden Rule √ • Operational Risks vrs Benefits? • Benefits to patients and parents versus value? • Discomfort Factor? • Financial Outlay & Total Treatment Duration
  26. 26. The End

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