Closing a Class III Open Bite Without Surgery

24-year-old female with Class III malocclusion, anterior open bite, 1 mm overjet, mild-to-moderate maxillary and mandibular crowding, maxillary lateral incisors in crossbite, and tongue thrust. Dental midlines are coincident. Tooth #8 has a history of trauma and is restored with a discolored crown; #30 is root-canal treated.

Patient

Adult (18–39), female

Classification

Class III

Active treatment

18 months

Published

September 14, 2026

Presentation

Chief complaint. "I want to fix my open bite and crowding."

Diagnosis. 24-year-old female with Class III malocclusion, anterior open bite, 1 mm overjet, mild-to-moderate maxillary and mandibular crowding, maxillary lateral incisors in crossbite, and tongue thrust. Dental midlines are coincident. Tooth #8 has a history of trauma and is restored with a discolored crown; #30 is root-canal treated.

Measurements

Cephalometric values before and after treatment
Measure	Norm	Pre	Post
SNA	82	82	82
SNB	80	77	77
ANB	2	5	5
Wits	0	-1	3
SN-MP	32	43	39
U1-SN	102	103	100
L1-MP	90	92	88
Overjet (mm)	2–3	0	1
Overbite (mm)	2–3	3	1

Treatment

Objectives. Correct the Class III relationship and close the anterior open bite without surgery. Achieve Class I molar and canine relationships, resolve crowding, coordinate the arches, intrude the maxillary posterior teeth, and promote mandibular autorotation to improve the vertical skeletal relationship and functional occlusion.

Plan. Extract the third molars, then use Invisalign to sequentially distalize the mandibular posterior teeth into a Class I relationship with Class III elastics. Intrude the maxillary posterior teeth and extrude the maxillary anterior teeth to close the open bite and promote mandibular autorotation. Level and align both arches, resolve crowding and crossbites, and use VPro+ as an adjunct during treatment.

Appliances and materials

Invisalign
Class III elastics
VPRO5 — vibrational therapy to help intrude molars since she is so hyperdivergent, weaker jaw muscles, cant clench as hard

Outcome

The open bite was successfully closed, the mandibular molars and canines were distalized into Class I relationships, and both arches were leveled and aligned. Incisal display on smiling was improved, resulting in a more balanced smile and functional occlusion.

Retention

Fixed L3-3 permanent retainer
Fixed U2-2 permanent retainer
Invisalign Vivera retainers to be worn at night