CASE STUDY Fig. 16 Fig. 18 Fig. 17 Other Methods to Close a Posterior Open Bite After Orthopedic Treatment Crowns or onlays may be placed on the posterior teeth to prostheti-cally close a posterior open bite. A different patient was treated with a Twin Force Bite Corrector 9 to unlock the posteriorized condyles (Fig. 18). Crowns were placed on the maxillary and mandibular posterior teeth (Fig. 19) maintaining the condyles in Gelb 4/7 position and restoring proper skeletal verti-cal dimension (Fig. 20). The patient wanted white posterior teeth -not my choice. Philosophically, I gener-ally will not place crowns or onlays on posterior teeth unless they are mutilated and/or have large restora-tions. Preparing virgin teeth with burs doesn’t seem right to me. Another method to close a posterior open bite is with an overlay partial (Fig. 21 and 22). Before you are too critical about the way this case appears, keep in mind this patient has been wearing this same overlay partial for over 35 years and says he could not function without it. In strong-muscled patients, the posterior teeth will intrude if an overlay prosthesis is worn for many years. With my current clinical knowledge, if this patient had presented for treat-ment today, I would have employed an overlay partial during the day and a nighttime Bionator to disclude the posterior teeth so that posterior intrusion would be minimized. Fig. 19 Fig. 20 Placing bonded posterior composite buildups is another method of closing a posterior open bite. I don’t often employ this technique, as the practitioner from then on is having to continually repair worn and broken composites – no thanks! www.orthodontics.com Spring 2022 35
Journal of the American Orthodontic Society Spring 2022: Page 35
