Nonextraction treatment of open-bite by sequential uses of tongue crib, temporary anchorage devices and myofunctional therapy: A case report of an adolescent

This report of a case describes the nonsurgical and nonextraction treatment of a female adolescent with severe skeletal open-bite using the tongue crib appliance, the quad-helix appliance, temporary anchorage devices (TADs) and myofunctional therapy. The tongue crib appliance and the quad-helix appliance were used to eliminate the digit sucking habit and to modify the tongue position. With TADs, the overerupted molars were intruded. After the post-active treatment, daily gum-chewing exercise for 15 min and lip closure training were performed to produce effective retention. Successful esthetic improvement from convex type profile to straight type profile was achieved, and post-treatment occlusal stability was maintained after 3-year retention with the strengthened masticatory muscle tone and modified tongue position.