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Cause of anterior open bite is generally multifactorial, which involves a combination of dental, skeletal and functional effects. It is one of the most difficult problems to treat in orthodontics. In severe adult cases, treatment usually requires surgical repositioning of the maxilla or mandible. When a patient rejects surgery, alternatives include extraction treatment, molar intrusion with skeletal anchorage, a vertical-pull chin cup, multiloop edgewise archwire (MEAW) therapy, or nickel titanium archwires with intermaxillary elastics. Although extrusion or eruption of anterior teeth is a common method of bite closure, it has been reported that extruded anterior teeth are less stable than intruded teeth. Extrusion of maxillary anterior teeth might also compromise facial esthetics, especially in a patient with a gummy smile and high mandibular plane angle. In such cases intrusion of upper posterior teeth is the treatment of choice.
The maxillary posteriors can be successfully intruded using infrazygomatic screws which will cause autorotation of the mandible.
This case report shows the use of a "Disintrusion Splint" which can achieve both intrusion and distalization simultaneously in cases where the proclination also needs to be corrected.