Open bite: Spectrum of treatment potentials and limitations

Treatment of open bite malocclusion is complex and challenging because of the potential for relapse and the possibility of compromised esthetics. The aim of this article is to emphasize the importance of tailoring treatment to the specific individual characteristics and etiology of the open bite. The treatment approaches are discussed separately for early treatment of growing and non-growing patients. Treatment ranges from correction of etiologic habits to control of hyperdivergent growth and dentoalveolar vertical hyperplasia. Technological advances (plates and screws) have expanded the sphere of success, but long-term studies and controlled clinical trials are needed. Limitations of treatment include the persistence of known etiologic factors and initial growth pattern, the difficulty to accurately predict the individual course of development or the response to treatment, lack of knowledge of biological mechanisms behind open bite development, periodontal and mechanical considerations, and the increased risk of iatrogenic effects. Judgment of the individual conditions defining the malocclusion and non-heroic mechanics should guide the clinician in the attainment of stable and esthetic results.