2020 Winter Conference - Treatment of Open Bite in the Mixed Dentition: The Long-term Challenge

Credits: None available.

Open bite represents a serious challenge in dentofacial orthopedics. This lecture will describe the dentoskeletal effects produced by different types of appliances for the treatment of dentoskeletal open bite in the mixed dentition (quad helix with crib, open bite Bionator, removable plate with crib, rapid maxillary expansion and vertical pull chin cup). The effects produced by rapid maxillary expansion in prepubertal open bite patients will be also illustrated. The long-term stability of open bite treatment will be analyzed by reporting the results of 2 studies on the effects of quad-helix/crib therapy and rapid maxillary expansion in association with posterior bite blocks in open bite growing patients.

Learning Objectives:

• Comprehend the dentoskeletal effects produced by different protocols for the treatment of open bite patients.
• Identify that an increased mandibular plane angle is not a contraindication for rapid maxillary expansion.
• Identify the long-term dentoskeletal effects produced by quad-helix/crib therapy and rapid maxillary expansion in association with posterior bite blocks in open bite growing patients.

2020 Winter Conference - Silver-Bullet Breakthrough? Mandibular Autorotation Concept (MAC) Surgery: Rationales and Outcomes

Credits: None available.

Osteoarthritis of the temporomandibular joint causes marked retrusion of the mandible and open bite. To date, several surgical orthodontic treatment modalities have been performed, but prognosis and postoperative stability are poor, because of relapse and condylar resorption. Mandibular autorotation concept (MAC) surgery performed at our hospital is a broad term to describe the series of orthognathic surgery utilizing an intentional mandibular autorotation. In this presentation, I would like to share with you the backgrounds and effectiveness of the MAC surgery with the basic and clinical data.

Learning Objectives:

• Explain the backgrounds of orthognathic treatment of mandibular retrusion and open bite due to condylar changes.
• Recognize the rationales to propose the orthognathic treatment using mandibular autorotation concept (MAC) surgery.
• Evaluate the reproducibility and stability of orthognathic treatment using MAC surgery.

2020 Winter Conference - Relevant Differences Between Non-extraction and Extraction Openbite Treatment

Credits: None available.

This lecture will demonstrate the important factors that play a role in the decision of treating an open bite without or with extractions. The mechanisms of action with these two approaches will be illustrated and their implications for treatment results and stability will be addressed. Scientific evidences on the different stabilities provided by both open bite approaches will be explained. Clinical procedures to increase treatment stability will also be shown.

Learning Objectives:

• Diagnose when to treat an open bite without and with extractions and to know the mechanism of action of each approach.
• Know the percentage of clinical stability provided by non-extraction and extraction open bite treatment, based on scientific evidences.
• Increase treatment efficiency and stability with several additional clinical procedures.

2020 Winter Conference - Open Bite: Are We Treating the Right Causes?

Credits: None available.

Anterior open bite is considered one of the malocclusions of most difficult treatment, especially regarding stability. The literature presents many researches on this subject, but with controversial information. There are disagreements on the definition of open bite, its etiology and types of treatment. Possibly, the lack of consensus on the etiology of the anterior open bite may have led to different types of treatment and can be the explanation for the high level of relapse of this malocclusion. The purpose of this presentation is to review the concepts of anterior open bite focusing on etiology, treatment methods and their stability and present criteria for the diagnosis and treatment of this malocclusion, based in its etiology, with examples of treated cases, stable for over 10 years.

Learning Objectives:

• Identify the etiological factors for anterior open bite.
  
• Analyze different tongue positions at rest and its implication on open bite treatment.
  
• Evaluate the importance of function on open bite treatment stability.
  

2020 Winter Conference - Managing Skeletal Open Bites with the Use of Clear Aligners

Credits: None available.

In this lecture, Dr. Shen Garnett will explain how clear aligners can be used to control the vertical, its capabilities and limitations. An overview of stability and mechanics used to close open bites will also be covered. She will also outline a comparison of the effectiveness of clear aligners to fixed appliances and closing open bite.

Learning Objectives:

• Increase confidence in using clear aligners to close open bites.
• Comprehend the biomechanics involved in controlling the vertical.
• Recognize that fixed appliance TADs and surgery is not the only option in closing open bites and the results and stability using clear aligners may be just as good and maybe better.

2020 Winter Conference - Form and Function: Anterior Open Bites and the Role of Oral Myofunctional Therapy

Credits: None available.

Abnormal tongue positioning is associated with open bites as well as other aspects of malocclusions. Having correct tongue posture and activity are important aspects of successful orthodontic treatment and long term stability. With orthodontic treatment of open bites, the tongue’s environment is changed with the intent that tongue positioning will become normalized. With myofunctional therapy, training exercises are used to correct tongue positioning, which can then lead to improved structure of the mouth. While each approach can have positive treatment results, this presentation will focus on evidence related to treatment outcomes when both form and function are simultaneously addressed.

Learning Objectives:

• Comprehend the developmental relationship of tongue posture to anterior open bites.
• Recognize potential limitations of orthodontic treatment if tongue function remains abnormal.
• Appreciate the synergistic impact of combining orthodontic and myofunctional therapy in achieving long term success when correcting open bite malocclusions.

2020 Winter Conference - Contemporary Multiloop Edgewise Archwire (MEAW) Technique: Old-fashioned but Useful

Credits: None available.

In 1967, Young H. Kim created the multiloop edgewise archwire (MEAW) to treat open bite malocclusions, which he achieved with great efficiency. Subsequently, Prof. Young-il Chang (Seoul National University, Seoul, Korea) studied the MEAW mechanics to establish the principles. Young H. Kim applied it to all types of malocclusions. MEAW can be constructed with stainless steel 0.016 × 0.022 (bracket 0.018 inch slot) or 018 x 0.022 or 0.017 × 0.025 ss (bracket 0.022 inch slot). The MEAW requires wire bending, which seems very old-fashioned, but it is still very useful in many cases. This lecture will present both old and contemporary cases allowing the audience to easily understand the MEAW techniques.

Learning Objectives:

• Familiarize yourself with the MEAW technique, especially for open bite.
• Identify the indications and contraindication of MEAW techniques.
• Evaluate the procedures of MEAW fabrication and application.

2020 Winter Conference - Buccal Shelf (BS) Screws for Class III Openbite Correction

Credits: None available.

Common anterior open bite corrections include extractions and a variety of appliances, such as, high-pull headgear, bite blocks, and elastics. In more severe cases, orthognathic surgery is required to correct the skeletal malocclusion. While surgery proves to be a reliable treatment option, many patients reject it for the prohibitive cost, pain and long recovery time. Recently, TADs have allowed orthodontists to treat some of these patients without orthognathic surgery through intrusion of the posterior mandibular molars and rotate the occlusal plane. They provide a treatment alternative for mild-to-moderate open bite cases without other skeletal contributing factors. This lecture will demonstrate how to properly identify and eliminate the etiology of anterior open bite and create effective strategies to correct it with buccal shelf (BS) TADs and extractions. After this lecture, you’ll be able to apply BS screws in your daily practice.

Learning Objectives:

• Identify the etiology of anterior open bite.
• Articulate the biomechanics of BS screws in the correction of anterior open bite.
• Locate the buccal shelf and explain steps of BS screw placement.

2020 Winter Conference - Anterior Openbite Correction: Surgery vs. TADs

Credits: None available.

Anterior open bite (AOB) can be corrected by orthognathic surgery or orthodontic treatment. Severe skeletal, facial, and functional problems should be corrected by orthognathic surgery, but combining cone-beam computed tomography (CBCT) and temporary anchorage devices (TADs) can provide an efficient and accurate way to correct AOB. Nowadays, by using TADs, we can expand orthodontic boundaries. In this lecture, various clinical applications of TADs and orthognathic surgery will be discussed in challenging AOB cases along with new American Board of Orthodontics (ABO) Scenario-based Oral Clinical Examination domains. After the lecture, clinicians will be able to treat and finish anterior open bite cases more efficiently and successfully while minimizing the chance of relapse.

Learning Objectives:

• Discuss how to prepare the new ABO Scenario-based Oral Clinical Examination in diagnosis and treatment planning, treatment implementation and management, and critical analysis and outcomes assessment in AOB cases.
• Identify clinical situations in which CBCT imaging and TADs are beneficial in AOB correction.
• Evaluate clinical applications and biomechanical considerations of orthognathic surgery vs. TADs in challenging AOB cases.

2020 Webinar - Manipulating Curve of Spee with Aligners: Control Deepbites and Openbites

Credits: None available.

A part of any comprehensive orthodontic plan is the need to control the curve of spee and at the same time the vertical dimension of the patient. Learn how to customize the opposing curve of spee changes in the upper and lower arches of aligner treatments. Learn how to use the curve of spee changes in aligner treatments to both open deepbite cases, and close openbite cases.

Objectives:

• Customize appropriate intrusions and extrusions to change the curve of spee in different malocclusions.
  
• Choose the appropriate anchorage teeth and attachments to support changes desired.
  
• Explain how to open or close the vertical dimension of patients with aligner orthodontics.
  
• Explain how to introduce inter-arch elastics to add more control to curve of spee customizations.
  

Bio: Dr. William Dayan received his DDS from the University of Toronto in 1986. Following a year of general practice residency at the Montreal Jewish General Hospital and two years in private general practice, he returned to the University of Toronto and completed his diploma in Orthodontics in 1991. Dr. Dayan attends the Pankey Institute for Advanced Dental Education. Over the last 10 years Dr. Dayan has lectured worldwide about Aligner Orthodontics, and how to get great results in all types of cases. He himself has treated over 3,400 cases and coached over 13,000 ClinChecks for other clinicians.

Speaker Disclosure:
Consultant: Your Ortho Coach

Length of session:
The session is scheduled for 75 minutes.

Continuing Education:
Each participant who completes the Webinar will earn 1.25 CE for the entire session.

Continuing Education Disclaimer:

This Continuing Education Program provides attendees with a relevant and rewarding continuing education experience. However, neither the content of a course nor the use of specific products in any program should be construed as indicating endorsement or approval of the views presented or the products used by the AAO or by any of the respective subsidiaries. Speakers are required to disclose to participants any financial, commercial or promotional interest in a product or company that may influence their presentations; however, the AAO shall not be liable for a speaker’s failure to disclose such interest.

American Association of Orthodontists is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual lectures or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.