Although patients with skeletal open-bite defor- mities exhibit a spectrum of skeletal, dental, neu- romuscular, and esthetic abnormalities
well, f**k. I wonder what, if anything, can be done about this.
Their studies showed no significant difference in the maxillary occlusal plane angle; however, the man- dibular occlusal plane angle was significantly greater in all open-bite cases than in controls. This finding sug- gests that the open-bite deformity arises below the maxillary dentition.
Bizarre. Why then, is posterior impaction the movement used to close the open bite?
Sassouni and Nanda?? found that the mandibular condyle was located in a superior position, thereby in- directly decreasing effective ramus height and thus producing a larger mandibular plane angle. These findings suggest that the high mandibular plane angle consistently found in open-bite patients is due to an effectively shorter mandibular ramus and an opening rotation of the mandibular ramus.
Well there it is. seems repositioning the condyles and, if necessary, increasing the overall vertical length of the ramus would be more effective. whether that form of treatment exists, i dont know
An increase in maxillary posterior dentoalveolar height is another commonly cited factor in open-bite Cases,?.:?4.:??.4:?.15 However, Nahoum and co-workers?? did not find any significant difference in posterior max-illary dentoalveolar height between their open-bite and normal samples. Therefore, no consensus exists as to the relationship of posterior dentoalveolar hyperplasia to open bite.
One of the most distinguishing features of the skeletal open-bite population is that the total anterior facial height is greater than that in a normal popula- tion ,T.:i4.:iT,. I I .4X-.32 Most studies show that this in- crease occurs primarily in the lower anterior facial height or in the area below the anterior nasal spine? .? rather than in the upper an-
terior facial height, which remains normal??J5,?? or is shorter in open-bite patients.??,This indicates that most of the deformity occurs below the level of the palate.
So no elongation of the upper midface then...