Non-Surgical Open Bite Treatment with Clippy-C in a Patient in Their 30s: No-Prep Laminate Treatment Period of 2 Years

Hello.

Today, I’d like to talk about treatment for severe open bite.

2023.05~2025.05

Open bite treatment can be done with orthodontics or with double-jaw surgery.

The reason it is described as severe is that the amount of anterior tooth separation is 5 mm or more.

The 기준 for whether double-jaw surgery is needed or orthodontic treatment is possible is considered to be an open bite amount of 5 mm.

There are two treatment methods for anterior open bite. Either intrude the molars or pull the front teeth down. Usually, the problem is solved by molar intrusion movement because it has a lower tendency to relapse and also gives the effect of shortening the lower face. However, if the amount of anterior open bite exceeds 2–3 mm, molar intrusion alone is not enough. Anterior extrusion and molar intrusion must be done at the same time.

Today, I’ll talk about that.

23.05

This is a patient in their 30s who came in two years ago for treatment of anterior open bite.

23.05

Because the amount of front tooth separation was 5 mm, this was right on the borderline for double-jaw surgery, but since the patient had no intention of undergoing surgery, we decided to address it with orthodontics alone.

23.05

We also decided to correct the slightly crooked front teeth and began treatment. Clippy-C orthodontics was recommended.

During the molar intrusion period, appliances are not attached to the front teeth. This minimizes the time needed to wear the Clippy-C appliance and is also more comfortable for the patient.

23.10

Five months after starting treatment, the open bite had already been greatly improved with molar intrusion alone.

23.10

As you can see in the photo, the molars were intruded almost to the point of being buried in the gums, so the remaining open bite now had to be solved from the front teeth. From this point on, Clippy-C appliances were attached to both the upper and lower arches to extrude the front teeth.

24.05

This is how it looked one year after treatment started.

The alignment, bite, and everything else were favorable, so after continuing finishing orthodontics for another five months, we began preparing for no-prep laminate treatment, Gelami.

24.10

This is how it looked one year and five months after treatment began. First, we removed the upper appliance and prepared for fitting.

The lateral incisor indicated by the blue arrow is a dwarf-tooth laminate that the patient had done a long time ago.

We also decided to remove and remake this laminate.

It takes 7 days for the fitting materials to arrive.

This is the fitting stage.

At this stage, we incorporate the patient’s needs and proceed with Gelami fabrication.

Gelami fabrication takes 10 days.

This is how it looked after Gelami placement.

24.11

The broken front tooth area was neatly restored.

We proceeded with 100% no-prep.

During the three weeks of laminate treatment, we monitor how well the orthodontic result is maintained without wires.

As expected, a small amount of the open bite recurred, so we attached hooks for rubber bands and continued treatment with elastics.

And in May 2025, we finally completed treatment after two years.

25.05

The bite is good and the midline is well aligned.

23.05~25.05

Retainers were also carefully placed.

To prevent open bite relapse, Vivera is a good option for firmly holding the teeth in place. We recommended Vivera fabrication, and we are currently waiting for the Vivera appliance to arrive.

Now, let’s look at the before-and-after comparison.

23.05~25.05

23.05~25.05

23.05~25.05

Now that the open bite has been resolved, the patient can bite into food with the front teeth.

In addition, you can see the effect of a shorter lower face.

Now let’s compare the facial photos before and after.

23.05~25.05

As the molars were intruded, the mandible autorotated and the lower face became significantly shorter, which is also noticeable in the frontal photos.

23.05~25.05

25.05

No root resorption is visible, and the root alignment is good.

Looking at the overall treatment results over two years, the molars were intruded by 3 mm, and the front teeth were extruded by 1 mm each in the upper and lower arches, fully resolving the open bite.

Thanks to the intruded molars, the lower jaw closed more and underwent autorotation, which shortened the lower face.

I hope this post helps those who are struggling with severe open bite, and I’ll end here.

#ApgujeongOrthodonticClinic #IntrusionOrthodontics #NoPrepLaminate #Gelami #GangnamLaminate #GangnamNoPrepLaminate #ApgujeongLaminate