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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

Hyung-Kyu Noh
Hyung-Kyu Noh
, 
Ho-Jin Kim
Ho-Jin Kim
 oraz 
Hyo-Sang Park
Hyo-Sang Park
   | 20 mar 2024
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Data publikacji: 20 mar 2024
Zakres stron: 200 - 211
Otrzymano: 01 kwi 2022
Przyjęty: 01 wrz 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.

Figure 1.

Pretreatment records, including extraoral and intraoral photographs, cephalogram, panoramic radiograph, and three-dimensional virtual model.
Pretreatment records, including extraoral and intraoral photographs, cephalogram, panoramic radiograph, and three-dimensional virtual model.

Figure 2.

Vertical holding appliance. A, Mechanism of the vertical holding appliance combined with the smile–clenching–swallow exercise. (a) Resin button of the appliance. A space of approximately 3 mm is present between the resin button and palate. (b) Dorsal surface of the tongue. (c) Functional force applied on the resin button by the tongue. (d) Vertical force acting on the first molars transmitted through the appliance. (e) Tongue-reminding effect by the resin button. B, Positive feedback chain between the smile–clenching–swallow exercise and the vertical holding appliance. C, Upper occlusal view. D, Pressure mark on the dorsal surface of the tongue after the smile–clenching–swallow exercise.
Vertical holding appliance. A, Mechanism of the vertical holding appliance combined with the smile–clenching–swallow exercise. (a) Resin button of the appliance. A space of approximately 3 mm is present between the resin button and palate. (b) Dorsal surface of the tongue. (c) Functional force applied on the resin button by the tongue. (d) Vertical force acting on the first molars transmitted through the appliance. (e) Tongue-reminding effect by the resin button. B, Positive feedback chain between the smile–clenching–swallow exercise and the vertical holding appliance. C, Upper occlusal view. D, Pressure mark on the dorsal surface of the tongue after the smile–clenching–swallow exercise.

Figure 3.

Records at 3 months of treatment, including extraoral and intraoral photographs, cephalogram, and superimposition of radiographs taken before treatment and after 3 months of treatment.
Records at 3 months of treatment, including extraoral and intraoral photographs, cephalogram, and superimposition of radiographs taken before treatment and after 3 months of treatment.

Figure 4.

Intraoral photographs. (A) At 16 months of treatment. (B) At 25 months of treatment.
Intraoral photographs. (A) At 16 months of treatment. (B) At 25 months of treatment.

Figure 5.

Records at 30 months of treatment, including extraoral and intraoral photographs, cephalogram, and superimposition between 3 months and after 30 months of treatment. The photographs were taken immediately after bonding braces.
Records at 30 months of treatment, including extraoral and intraoral photographs, cephalogram, and superimposition between 3 months and after 30 months of treatment. The photographs were taken immediately after bonding braces.

Figure 6.

Post-treatment records, including extraoral and intraoral photographs, three-dimensional virtual model, panoramic radiograph, cephalogram, and superimposition of radiographs taken at 30 months of treatment and post-treatment. All post-treatment records were taken after debonding braces.
Post-treatment records, including extraoral and intraoral photographs, three-dimensional virtual model, panoramic radiograph, cephalogram, and superimposition of radiographs taken at 30 months of treatment and post-treatment. All post-treatment records were taken after debonding braces.

Figure 7.

Retention records. (A) Extraoral photographs at 1-year follow-up. (B) Extraoral photographs at 3-year follow-up. (C) Intraoral photographs at 1-year follow-up. (D) Intraoral photographs at 3-year follow-up.
Retention records. (A) Extraoral photographs at 1-year follow-up. (B) Extraoral photographs at 3-year follow-up. (C) Intraoral photographs at 1-year follow-up. (D) Intraoral photographs at 3-year follow-up.

Figure 8.

Cone-beam computed tomography superimposition between post-treatment and 3-year follow-up images. Yellow and red dots denote the post-treatment measurements and 3-year follow-up measurements, respectively. (A) Lateral view. More prominent forward growth of the mandible than the maxilla. (B) Frontal view. Menton deviation to the left.
Cone-beam computed tomography superimposition between post-treatment and 3-year follow-up images. Yellow and red dots denote the post-treatment measurements and 3-year follow-up measurements, respectively. (A) Lateral view. More prominent forward growth of the mandible than the maxilla. (B) Frontal view. Menton deviation to the left.

List of abbreviations

Abbreviations Definition
MFT Myofuncional therapy
VHA Vertical holding appliance
TPA Transpalatal arch
CBCT Cone-beam computed tomography

Cephalometric measurements

Measurements Pre treatment 3 months 30 months Post treatment 3-year retention
Anteroposterior SNA (°) 78.1 78.1 78.3 78.3 76.3
SNB (°) 76.8 78.1 78.4 77.7 78.1
ANB (°) 1.4 0 -0.1 0.6 -1.8
A to N-perp (mm) -6.72 -7.7 -7.2 -6.9 -7.4
Pog to N-perp (mm) -14.4 -11.8 -10.2 -11.7 -9.8
Vertical SN to palatal plane angle (°) 4.1 4.1 2.9 2.9 2.5
SN to occlusal plane angle (°) 25.2 25.4 26.7 26.8 24.6
SN-GoMe (°) 38.5 36.4 37.4 38.5 38.4
Anterior Facial Height (AFH) (mm) 117 113.5 119.2 122.3 128.8
Posterior Facial Height (PFH) (mm) 72.1 70.8 73.9 75.2 80.4
Facial height ratio (PFH/ AFH) 0.62 0.62 0.62 0.61 0.62
Dental U1 to FH (°) 114.9 114.2 115.2 106.3 113.4
IMPA (°) 90.6 87.3 87.3 83.7 83.6
Interincisal Angle (°) 120.9 126.3 124.8 136.3 132.8
eISSN:
2207-7480
Język:
Angielski
Częstotliwość wydawania:
Volume Open
Dziedziny czasopisma:
Medicine, Basic Medical Science, other
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