Bella Smile ↗Case report · Aligners + acceleration
Open bite Closed without Surgery, declined elsewhere
22-year-old male wants to close his 6mm anterior open bite. He can't eat well or bite into food and is self-conscious of how it looks when he talks. His back molars are wearing down and the dentin is starting to be exposed on the lower molars.
- Patient
- Adult (18–39), male
- Classification
- Class III
- Active treatment
- 15 months
- Published
- September 7, 2026
Presentation
Chief complaint. “I want to close my open bite and close my lower spacing.”
Diagnosis. Skeletal and dental Class III open bite. Severely hyperdivergent mandibular plane angle, thereby masking the Class III malocclusion. The upper incisors are slightly proclined, and the lower incisors are well positioned. Anterior tongue thrust present upon swallowing. Condyles appear round, and all third molars are present. The lower third molars are impacted
Records
Before — Intraoral Photos
After — Intraoral Photos
Before — Lateral Ceph Radiograph
After — Lateral Ceph Radiograph
Before — Panoramic Radiograph
After — Panoramic RadiographMeasurements
| Measure | Norm | Pre | Post |
|---|---|---|---|
| SNA | 82 | 82 | 82 |
| SNB | 80 | 79 | 81 |
| ANB | 2 | 3 | 0 |
| Wits | 0 | 0 | -2 |
| SN-MP | 32 | 37 | 34 |
| U1-SN | 102 | 107 | 107 |
| L1-MP | 90 | 92 | 80 |
| Overjet (mm) | 2–3 | 0 | 2 |
| Overbite (mm) | 2–3 | -6 | 2 |
Treatment
Objectives. Achieve Class I molar and canine relationships Close the open bite; increase overbite and overjet Close lower spaces Distalize lower teeth to Class I Intrude posterior teeth and extrude anterior teeth to level the curve of Spee
Plan. Utilized Invisalign with VPro+ and Class III elastics. Extracted the third molars, then sequentially distalized the second molars, then the first molars, then the premolars, and then the 6 anterior teeth. Intruded the molars simultaneously to help close the open bite. Intruded the upper molars more than the lower molars, as my published papers show that you achieve more upper molar intrusion than lower molar intrusion. Refer to myofunctional therapist to work on Tongue trust exercises.
Appliances and materials
- Invisalign
- Class III 3/16 Heavy elastics
- Vpro5
Outcome
Achieved Class I molars and Canines. Closed down open bite. Increased overjet. Duration: 15 months, # of Aligners: 31, Refinement #1-20 aligners , Refinement #2 -14 aligners, Refinement #3 -12 aligners, Aligner change: 7 days
Retention
Fixed U3-3 and L3-3 Vivera retainers to be worn at night
Case reports are shared with patient authorisation. Individual results vary.