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Anterior open bite cases are very challenging to manage due to the high relapse potential associated with this feature of malocclusion. It is helpful if the aetiology is established before embarking on treatment to ensure that the appropriate treatment modalities are carried out. Determining whether the aetiology of an anterior open bite is caused by an ‘endogenous tongue thrust’ is extremely difficult. In particular, differentiating between an adaptive and endogenous tongue thrust can be extremely challenging. The case study presented explores the clinical considerations when diagnosing and treating anterior open bites.
CPD/Clinical Relevance: This report raises the question: is it possible to diagnose an endogenous tongue thrust?
Article
An anterior open bite (AOB) is defined as the lack of vertical overlap of the upper over the lower incisor teeth. The incidence ranges from 1.5% to 11% with variation in age and ethnic origin.1 Patients usually seek treatment for AOB because of the appearance or due to poor function, that is, the inability to bite through food effectively. In the permanent dentition, AOBs are very challenging to treat and manage, as they are known to have a high rate of relapse.2,3,4 Factors attributed to relapse are tongue posture, growth pattern, treatment considerations and surgical instability.5,6,7 It is therefore paramount to establish the aetiology before embarking on treatment to ensure that the appropriate treatment modalities are carried out.
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