Invisalign Open Bite Correction: Molar Intrusion, Verrara?

Hello

This is Apgujeong Invisalign Dental Clinic.

Today is another Invisalign post.

Invisalign is a good treatment method for open bite treatment.

Today, I’ll show a case in which an anterior open bite was treated with Invisalign, along with changes in chin position.

23.11

This patient visited us in November 2023 for open bite treatment.

The patient also felt that the front teeth were protruding.

If extraction orthodontic treatment were done by extracting four premolars, the anterior open bite itself would likely be solved easily as the front teeth moved backward.

But the lip line is so beautiful that it could become less attractive due to extraction treatment.

23.11

We decided to resolve the uneven tooth alignment by moving the molars backward using the space from the wisdom teeth, and to resolve the anterior open bite through molar intrusion.

Molar intrusion was planned using orthodontic mini-screws placed in the palate.

Posterior movement into the wisdom tooth space also requires mini-screws.

As for arch expansion, we did not perform it separately because the arch was not actually narrow; the first premolar was simply tilted toward the palate.

After starting aligner number 1 in December 2023, the patient completed all 51 aligners by January 2025.

25.01

The anterior open bite was resolved, but about 1 mm of mismatch in the anterior midline remained.

The right molar occlusion is slightly open.

The left molar occlusion is good.

The alignment is also good.

A total of four orthodontic mini-screws were placed: two on the upper jaw and two on the lower jaw.

Within the first set of 51 aligners, maxillary molar intrusion and mandibular molar distalization using mini-screws progressed well.

We then began making additional aligners with the goals of stabilizing the bite and improving the midline.

There were 12 additional aligners, and they were worn for three months from February to April 2025.

Treatment was completed in April 2025. The midline is now aligned accurately.

After the wire retainer was attached, the patient chose Vivera as the removable retainer. While waiting the two weeks for Vivera fabrication, rubber bands were hooked between the metal hook shown in the photo and the lower mini-screw to maintain the occlusion of the teeth that had been open at the initial visit.

Because those teeth were initially elevated, if no appliance were worn after the wire retainer was attached, they would slightly reopen again due to relapse.

The molar occlusion is good.

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

The alignment is good, and the wire retainer is attached as well.

23.11~25.04

23.11~25.04

Let’s look at the facial changes.

Clean smile line and lip contour

Appropriate front tooth angulation

Now let’s look at the self-rotation effect of the mandible caused by molar intrusion.

If you squint, compared with the beginning, the lower face looks slightly shorter, and the chin has become a little more prominent and fuller.

It would have been a big problem if extraction had been done.

There is no root resorption, and the root parallelism is good.

If you are considering orthodontic treatment for an open bite, I hope this post was helpful.