Abstract

Open bite malocclusions have long been among the most challenging problems in orthodontics—not only to treat, but especially to retain. When combined with other malocclusions such as a narrow maxilla, Class II, Class III, or asymmetries, these cases can become even more complex, and in many situations, nearly impossible to treat successfully with traditional orthodontics. Often, they are resolved only through orthognathic surgery or by compromising with incisor extrusion.

The development of skeletal anchorage devices has provided a genuine alternative for certain open bite cases. This lecture will introduce some of the most effective and predictable techniques for molar intrusion using skeletal anchorage to close the open bite. It will also present surprising long-term findings regarding stability and relapse after molar intrusion, revealing new insights into diagnosis, treatment design, and strategy—insights that can significantly improve long-term outcomes.

Participants will learn about optimal miniscrew insertion sites, appliance designs, and retention protocols, as well as the biomechanical principles behind them. Clinical tips and troubleshooting advice will be provided to help clinicians refine their approach.

One of the primary aims of this clinically oriented session is to inspire a shift in the way open bite cases are approached, moving beyond conventional methods toward strategies with proven stability. While some relapse remains inevitable, treatments involving skeletally anchored mesialisation, distalisation, expansion, and Class III correction have demonstrated far higher long-term stability.

The lecture will conclude with clear recommendations on appliance design, treatment timing, and protocols—equipping participants with practical, evidence-based solutions for one of orthodontics’ most persistent challenges.

Learning Objectives

• To be able to recognize patients with good indication for molar intrusion versus patients with the need for orthognathic surgery. 
• To be able to identify the aetiology of the open bite and to evaluate the amount of the remaining growth.
• To be able to sketch and construct the appliance needed to fulfil treatment objectives.
• To be able to utilize and use and activate the appliance and to give the proper instructions and design treatment progress in a proper way.
• To be able measure and analyse treatment results and evaluate the stability and prognoses.