Non-Surgical Treatment of a Skeletal Class II Patient with Anterior Open Bite and Distal Impaction of the Mandibular Second Molars

Anterior open bite can result from various factors, including skeletal, dental, functional, and habitual elements, and it has a high tendency for relapse. Therefore, careful consideration is necessary in diagnosis, treatment planning, and managing the treatment process and retention. A 16-year-old male presented with anterior open bite and bilateral impaction of the mandibular second molars. The patient exhibited a severe Class II skeletal relationship with vertical excess growth pattern. Severe crowding of the maxillary dentition and transverse discrepancy were observed. Furthermore, we observed bilateral impaction of the mandibular second molars, along with lip incompetence and inadequate exposure of the incisors. The treatment strategy involved anterior teeth extrusion and posterior teeth intrusion in the maxillary dentition. In the mandibular dentition, a stabilizing passive wire was utilized to minimize the distal tipping of the mandibular first molars during traction of both mandibular second molars. Subsequently, miniscrews were used to intrude the posterior teeth, promoting counterclockwise rotation of the mandible, resulting in achieving a stable occlusal relationship.