20/06/2026
A patient presented with a severe anterior open bite extending into the posterior segments, resulting in both anterior and posterior open bite malocclusion. Clinical examination revealed a persistent tongue-thrust swallowing pattern and abnormal tongue posture, which were considered the primary etiological factors contributing to the malocclusion. The patient exhibited protrusion of the mandibular dentoalveolar arch accompanied by generalized spacing, particularly in the lower anterior region.
Extraoral examination demonstrated incompetent lip seal at rest and increased lower facial height. Intraoral findings included a lack of vertical overlap between the maxillary and mandibular incisors, absence of occlusal contact in the posterior segments, proclination of the lower incisors, and spacing within the mandibular arch. Functional assessment confirmed tongue interposition during swallowing and speech.
Comprehensive orthodontic treatment was carried out using a fixed appliance system in both arches. The treatment objectives included elimination of the open bite, correction of the protrusive mandibular dentition, closure of residual spaces, establishment of proper overbite and overjet, and achievement of stable functional occlusion. The patient underwent active orthodontic treatment for approximately two years, during which vertical control mechanics, space closure, arch coordination, and habit correction measures were implemented.
At the completion of treatment, satisfactory closure of both anterior and posterior open bites was achieved. Normal overbite and overjet relationships were established, mandibular arch spacing was eliminated, and a stable Class I occlusal relationship with improved esthetics and function was obtained. Retention was provided to maintain the treatment outcome and minimize the risk of relapse associated with the previous tongue-thrust habit.
