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<p>This case report aimed to describe the effectiveness of myofunctional therapy involving a vertical holding appliance and a smile–clenching–swallow exercise for vertical control, in a growing patient who presented with a high-angle facial pattern. A 10-year-old girl sought treatment for a skeletal open bite. Early interception aimed to reduce the divergent skeletal growth pattern. The patient was asked to perform a smile–clenching–swallow exercise by pushing the tongue dorsum against a palatal resin pad on a transpalatal arch. The action exerted an upward force on the maxillary first molars, which reinforced the effects of myofunctional therapy. This interaction between the tongue and resin pad resulted in positive feedback, and a constant intrusive force delivered to the molars and balanced co-operation from the orofacial musculature. The initial vertical skeletal discrepancy was successfully resolved within 3 months. The subsequent fixed appliance treatment was straightforward. After 3 years of follow-up, the treatment outcome was stable.</p>
</abstract>

This case report aimed to describe the effectiveness of myofunctional therapy involving a vertical holding appliance and a smile–clenching–swallow exercise for vertical control, in a growing patient who presented with a high-angle facial pattern. A 10-year-old girl sought treatment for a skeletal open bite. Early interception aimed to reduce the divergent skeletal growth pattern. The patient was asked to perform a smile–clenching–swallow exercise by pushing the tongue dorsum against a palatal resin pad on a transpalatal arch. The action exerted an upward force on the maxillary first molars, which reinforced the effects of myofunctional therapy. This interaction between the tongue and resin pad resulted in positive feedback, and a constant intrusive force delivered to the molars and balanced co-operation from the orofacial musculature. The initial vertical skeletal discrepancy was successfully resolved within 3 months. The subsequent fixed appliance treatment was straightforward. After 3 years of follow-up, the treatment outcome was stable.

Early interceptive treatment of a skeletal open bite using a vertical holding appliance in combination with myofunctional therapy, and a smile-clenching-swallow exercise: a case report with a 3-year follow-up

Australasian Orthodontic Journal

This work is licensed under the Creative Commons Attribution 4.0 International License.

This case report aimed to describe the effectiveness of myofunctional therapy involving a vertical holding appliance and a smile–clenching–swallow exercise for...

Early interceptive treatment of a skeletal open bite using a vertical holding appliance in combination with myofunctional therapy, and a smile-clenching-swallow exercise: a case report with a 3-year follow-up

Published Online: Mar 20, 2024

Page range: 200 - 211

Received: Apr 01, 2022

Accepted: Sep 01, 2023

DOI: https://doi.org/10.2478/aoj-2023-0032

© 2023 Hyung-Kyu Noh et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.