Closing a Class III Open Bite Without Surgery

I chose this approach because the patient could bring her front teeth into an edge-to-edge position, suggesting that a nonsurgical correction was worth considering alongside her other clinical findings. Her third molars were also present, giving us an opportunity to remove them and use the space to move the lower teeth backward sequentially. The plan addressed both the Class III relationship and the anterior open bite. After third-molar removal, we used Invisalign with Class III elastics to progressively distalize the lower posterior teeth into Class I molar and canine relationships. Because she was hyperdivergent, controlling the vertical position of the posterior teeth was particularly important. I chose aligners for their coverage of the biting surfaces and the ability to incorporate posterior intrusion into the plan. We intruded the upper posterior teeth to allow upward mandibular autorotation, helping close the open bite, and combined this with controlled extrusion of the upper front teeth to improve tooth contact and incisal display. Because upward rotation can also bring the lower jaw forward, we carefully coordinated open-bite closure with backward movement of the lower teeth. This approach allowed us to close her open bite, achieve Class I molar and canine relationships, and improve her smile without jaw surgery.** Fixed upper and lower retainers, together with nightly Vivera wear, were prescribed to help maintain the result.