2020 Winter Conference

Feb 7, 2020 ‐ Feb 9, 2020

All About Open Bites

Diagnosis and Treatment Options for Today’s Orthodontist

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Vertical Growth in Children, Development of Open Bites

Feb 7, 2020 8:45am ‐ Feb 7, 2020 9:15am

Development of the vertical dimension in human faces results from the interaction of environmental and genetic factors in a mosaic pattern of growth. Craniofacial morphology is often referred to as the result of "Form following Function." But how does this happen? This presentation will present an overview of how genetics, gene/protein expression, environmental factors and epigenetics are involved in the development of facial form.

Learning Objectives:
  • Comprehend how genetics fits in the Functional Matrix Theory.
  • Appreciate the various levels of how genetics and environment interact.
  • Gain a better understanding at the cellular level how to have Form follow Function and what will need to happen to maintain a change in Form.

Airway, Open Bites, and Sleep Apnea in the Orthodontic Office

Feb 7, 2020 9:15am ‐ Feb 7, 2020 10:00am

What do we know about the connection between airway obstruction and skeletal discrepancies such as the classic "adenoid facies"? Traditionally we are trained to analyze the airway using only the lateral view on a cephalometric film, but the airway is a three-dimensional structure, and that third dimension may be hiding something relevant to our diagnosis. This presentation will show how the orthodontist can help identify and manage obstructions and sleep apnea in pediatric and adult patients, and hopefully prevent anomalies in growth and development.

Learning Objectives:

  • Analyze both the nasal passage and the pharyngeal airway in 3D.
  • Identify the airway's role in craniofacial growth and development.
  • Identify how you can help your patients in your office without compromising efficiency.


Open Bite: Are We Treating the Right Causes?

Feb 7, 2020 10:30am ‐ Feb 7, 2020 11:15am

Anterior open bite is considered one of the malocclusions of most difficult treatment, especially regarding stability. The literature presents many researches on this subject, but with controversial information. There are disagreements on the definition of open bite, its etiology and types of treatment. Possibly, the lack of consensus on the etiology of the anterior open bite may have led to different types of treatment and can be the explanation for the high level of relapse of this malocclusion. The purpose of this presentation is to review the concepts of anterior open bite focusing on etiology, treatment methods and their stability and present criteria for the diagnosis and treatment of this malocclusion, based in its etiology, with examples of treated cases, stable for over 10 years.

Learning Objectives:

  • Identify the etiological factors for anterior open bite.
  • Analyze different tongue positions at rest and its implication on open bite treatment.
  • Evaluate the importance of function on open bite treatment stability.


Treatment of Open Bite in the Mixed Dentition: The Long-term Challenge

Feb 7, 2020 11:15am ‐ Feb 7, 2020 12:00pm

Open bite represents a serious challenge in dentofacial orthopedics. This lecture will describe the dentoskeletal effects produced by different types of appliances for the treatment of dentoskeletal open bite in the mixed dentition (quad helix with crib, open bite Bionator, removable plate with crib, rapid maxillary expansion and vertical pull chin cup). The effects produced by rapid maxillary expansion in prepubertal open bite patients will be also illustrated. The long-term stability of open bite treatment will be analyzed by reporting the results of 2 studies on the effects of quad-helix/crib therapy and rapid maxillary expansion in association with posterior bite blocks in open bite growing patients.

Learning Objectives:
  • Comprehend the dentoskeletal effects produced by different protocols for the treatment of open bite patients.
  • Identify that an increased mandibular plane angle is not a contraindication for rapid maxillary expansion.
  • Identify the long-term dentoskeletal effects produced by quad-helix/crib therapy and rapid maxillary expansion in association with posterior bite blocks in open bite growing patients.

Form and Function: Anterior Open Bites and the Role of Oral Myofunctional Therapy

Feb 7, 2020 1:45pm ‐ Feb 7, 2020 2:15pm

Abnormal tongue positioning is associated with open bites as well as other aspects of malocclusions. Having correct tongue posture and activity are important aspects of successful orthodontic treatment and long term stability. With orthodontic treatment of open bites, the tongue’s environment is changed with the intent that tongue positioning will become normalized. With myofunctional therapy, training exercises are used to correct tongue positioning, which can then lead to improved structure of the mouth. While each approach can have positive treatment results, this presentation will focus on evidence related to treatment outcomes when both form and function are simultaneously addressed.

Learning Objectives:
  • Comprehend the developmental relationship of tongue posture to anterior open bites.
  • Recognize potential limitations of orthodontic treatment if tongue function remains abnormal.
  • Appreciate the synergistic impact of combining orthodontic and myofunctional therapy in achieving long term success when correcting open bite malocclusions.

Relevant Differences Between Non-extraction and Extraction Openbite Treatment

Feb 7, 2020 2:45pm ‐ Feb 7, 2020 3:30pm

This lecture will demonstrate the important factors that play a role in the decision of treating an open bite without or with extractions. The mechanisms of action with these two approaches will be illustrated and their implications for treatment results and stability will be addressed. Scientific evidences on the different stabilities provided by both open bite approaches will be explained. Clinical procedures to increase treatment stability will also be shown.

Learning Objectives:
  • Diagnose when to treat an open bite without and with extractions and to know the mechanism of action of each approach.
  • Know the percentage of clinical stability provided by non-extraction and extraction open bite treatment, based on scientific evidences.
  • Increase treatment efficiency and stability with several additional clinical procedures.

The Use of Temporary Skeletal Anchorage Devices (TSADs) in Openbite Closure

Feb 7, 2020 3:30pm ‐ Feb 7, 2020 4:15pm

This lecture will show cases where TSADs were utilized to close open bites. A comparison to the stability of these cases to those cases treated with orthognathic surgery will be made. Emphasis on early treatment and the adolescent patient will also be presented. One case with eight years in retention will also be shown.

Learning Objectives:
  • Recognize the patient that is indicated for the use of TSADs in the closure of an open bite.
  • Recapitulate the protocol for the placement of the tasks and appliances to close an open bite.
  • Manage the retention phase of the open bite patient.

Q&A Discussion iconQ&A Discussion

Preview Available

Q&A Discussion

Feb 7, 2020 4:15pm ‐ Feb 7, 2020 4:45pm

Q&A Panel Discussion: All Friday Speakers


Managing Skeletal Open Bites with the Use of Clear Aligners

Feb 8, 2020 8:30am ‐ Feb 8, 2020 9:15am

In this lecture, Dr. Shen Garnett will explain how clear aligners can be used to control the vertical, its capabilities and limitations. An overview of stability and mechanics used to close open bites will also be covered. She will also outline a comparison of the effectiveness of clear aligners to fixed appliances and closing open bite.

Learning Objectives:
  • Increase confidence in using clear aligners to close open bites.
  • Comprehend the biomechanics involved in controlling the vertical.
  • Recognize that fixed appliance TADs and surgery is not the only option in closing open bites and the results and stability using clear aligners may be just as good and maybe better.

The Demonstration and Evaluation of Openbite Closure with Aligners

Feb 8, 2020 9:15am ‐ Feb 8, 2020 10:00am

Through the incipiency of clear aligner treatment, it has been demonstrated that the technique may offer excellent vertical control in the management of hyperdivergent type or anterior open bite malocclusions. Evaluation of techniques used to treat anterior open bites will be discussed in detail, in addition to benefits and detriments of this particular modality. Long-term stability will be evaluated, along with retention considerations.

Learning Objectives:
  • Better understand appropriate attachment design and nuances of the digital treatment planning process to effectively manage anterior open bite patients.
  • Identify the benefits and potential detriments to the patient if using clear aligners to close anterior open bites.
  • Evaluate retention considerations to help improve stability of anterior open bite correction in clear aligner patients.
Speaker(s): Disclosures
  • Mazyar Moshiri, DMD, MS, FICD : Consultant: Align Technology