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This article describes a clinically proven, pragmatic approach to managing anterior open bites (AOBs) by using additive, non-destructive, freehand direct resin composite bonding. Direct composite has been used by many clinicians to solve a multitude of clinical problems. The use of these techniques and the procedural aspects have been published extensively. However, in relationship to managing AOBs there appears to be an under-appreciation by some practitioners, as well as by some in the orthodontic and maxillofacial communities, of its pragmatic use for managing many AOBs, or about what additive direct resin composite bonding could offer those patients who enquire about their realistic options to deal with their perceived concerns.
CPD/Clinical Relevance: This article seeks to raise awareness about different ways of using direct resin composite bonding (‘bondodontics’) to manage many AOBs pragmatically, at very low risk and at reasonable costs.
Article
The available options for anterior open bites (AOBs) range from doing nothing, through to doing extensive, expensive and speculative treatments.
Variations of bonding direct composite have been devised by various clinicians to solve many clinical problems, using different techniques and processes, and these have been published widely.1 Using direct resin composite bonding to manage many anterior open bites is a useful and pragmatic clinical technique.
Orthodontics, on its own, or combined with facial surgery, are recognized approaches to managing AOB problems.2,3 However, Greenlee et al4 reported on the problems of relapse with different approaches. Huang et al5 described wide variations in the treatments offered for AOBs in different centres in the USA with many subjective, institutional, or commercial factors seemingly involved in the different orthodontic/orthognathic treatment decisions about managing AOBs. The many difficult issues associated with long-term retention, including when treating AOBs, have been reported extensively.6 The uncertainties and the possibilities of unsatisfactory long-term outcomes with orthodontics, as described by Talic in 2015,7 with or without jaw surgery, ought to be described candidly to any AOB patients, and/or their guardians, as part of good ‘Montgomery consent’ processes.
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