Bella Smile ↗Case report · Aligners + acceleration
Relapsed Open Bite After Jaw Surgery Successfully Retreated with Invisalign
35-year-old female with prior double-jaw surgery and subsequent condylar resorption presents with a recurrent Class II open bite.
- Patient
- Adult (21+), female
- Classification
- Class II div 1
- Active treatment
- 12 months
- Published
- September 16, 2026
Presentation
Chief complaint. 'I am concerned about my recurrent open bite and want to improve my bite without undergoing another major jaw surgery if possible."
Diagnosis. 35-year-old female with a skeletal and dental Class II malocclusion, convex facial profile, and history of maxillary first premolar extractions and two jaw surgery. She does not show much incisal show at rest. She presents with Class II molar and canine relationships, a premolar-to-premolar anterior open bite of approximately 3 mm, 4 mm overjet, mandibular midline deviation to the right, and mild maxillary and mandibular crowding. She has a history of double-jaw surgery complicated by condylar resorption and subsequent relapse.
This patient had already undergone jaw surgery to correct her open bite, but the bite relapsed. She did not want to have surgery again. For high-angle and open-bite patients, clear aligners are my treatment of choice because they give us something braces cannot provide in the same way: coverage of the biting surfaces and excellent vertical control. The plastic covers the back teeth, and biting and clenching against the aligners can support our planned molar intrusion while helping prevent unwanted molar extrusion. Why does that matter? The lower jaw functions like a hinge. When we intrude the back teeth, the lower jaw can rotate upward and forward (counterclockwise), helping the front teeth come together. Clinically, about 1 mm of posterior intrusion can produce roughly 3 mm of bite closure in the front, depending on the patient's anatomy. After treating hundreds of open-bite cases, we have found this approach highly effective. We then use clear retainers to help maintain posterior vertical control and protect the correction long term.
Records
Before — Intraoral Photos
After — Intraoral Photos
Before — Smile Facial Photos
After — Smile Facial Photos
Before — Lateral Ceph Radiograph
After — Lateral Ceph Radiograph
Before — Panoramic Radiograph
After — Panoramic RadiographMeasurements
| Measure | Norm | Pre | Post |
|---|---|---|---|
| SNA | 82 | 77 | 77 |
| SNB | 80 | 68 | 71 |
| ANB | 2 | 8 | 6 |
| Wits | 0 | 2 | 0 |
| SN-MP | 32 | 52 | 50 |
| U1-SN | 102 | 94 | 94 |
| L1-MP | 90 | 86 | 88 |
| Overjet (mm) | 2–3 | 4 | 2 |
| Overbite (mm) | 2–3 | -3 | 2 |
Treatment
Objectives. Close the recurrent open bite through posterior molar intrusion and mandibular autorotation, while allowing controlled maxillary incisor extrusion to improve incisor display at rest. Level the Curve of Spee, achieve ideal overjet and overbite, improve facial balance, and establish a stable functional occlusion without repeat jaw surgery.
Plan. Use Invisalign to intrude the posterior teeth, allowing the mandible to autorotate and close the open bite. Level and align both arches, level the Curve of Spee, and allow controlled extrusion of the maxillary incisors to improve incisor display. Use vibration therapy to improve aligner seating and facilitate posterior intrusion. Retain with posterior-coverage Invisalign retainers and bonded permanent retainers to maintain the correction.
Outcome
Successfully closed the recurrent open bite and achieved 2 mm overjet and overbite without repeat jaw surgery. Posterior intrusion and mandibular autorotation improved facial balance, while controlled maxillary incisor extrusion increased incisor display at rest.
Retention
- Fixed U2-2 permanent retainer
- Fixed L3-3 permanent retainer
- Invisalign Vivera retainers to be worn at night
Case reports are shared with patient authorisation. Individual results vary.