Embarrassing malocclusion: Hidden anterior open bite

Abstract

The development of an unexpected anterior open bite during orthodontic treatment can be quite embarrassing to the orthodontist. Before treatment, orthodontists must recognize that a hidden anterior open bite can be revealed when a patient with condylar distraction is treated with orthodontic tooth alignment or splint therapy. The disclosure of a hidden anterior open bite derives from resolving the protective neuromuscular reflex of the masticatory muscles or upward seating of the condyles. The use of articulator-mounted dental models and evaluation of the amount and direction of condylar distraction at the condylar level allows orthodontists to detect the possibility of a hidden anterior open bite. By intruding the posterior teeth, the anterior open bite can be corrected effectively.