Posterior open bite after treatment

I treated a patient with Clear Aligners and now I see a posterior open bite, why?
written by Dr. Sherif Kandil

Needless to say you are not the only one standing there and asking that question, there are many doctors who face this situation in their cases.

At the end of every clear aligner treatment the posterior teeth should show a stable occlusion with full vertical support. However, some patience have within the treatment specially after 6 months in treatment progress a posterior open bite.

Now imagine when you have layers of plastic on the posterior teeth patient wearing them all day and night, a normal result of this will be a tendency for the posterior teeth to get intruded thus, resulting in this transient posterior open bite.

Let’s approach this in a more scientific method, there are several factors that could lead to this:

1

The patient has a bruxing habit.

2

The overjet or overbite are not yet stable.

3

Not enough attachments on the posterior segments to hinder this intrusive movements

transient openbite

A transient openbite after
8 months treatment with K Clear

The openbite closed through using
partial aligners for 1 month only

There are several options to treat this temporary open bite after the treatment or even within the treatment.

Within treatment:

1

Using attachments

Use attachments on the posterior segments for the upper and lower teeth.

2

Adjusting the overjet and overbite

Adjust the overjet and overbite if necessary i.e. check the centric occlusion and if there are any abnormal habitual bites.

After the treatment:

Using elastics

Use elastics that bind the upper and lower posteriors segments i.e. through binding brackets, buttons or hooks to the upper and lower posteriors.

1

Cutting the aligner

Cut the aligner distal to the upper and lower canines to leave a partial aligner that covers only from canine to canine this will help posterior teeth to supererupt.

2

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