Anterior open bite: Rethinking diagnosis and treatment from a TMJ perspective

Document Type

Article

Publication Title

Seminars in Orthodontics

Abstract

Anterior open bite (AOB) has traditionally been diagnosed and treated based on skeletal, dental, and environmental factors. However, emerging evidence underscores the importance of evaluating the temporomandibular joint (TMJ) status as a fundamental component of anterior open bite management. AOB patients frequently exhibit condylar displacement and degenerative joint changes. In such cases, initiating orthodontic treatment without first ensuring TMJ stabilization may compromise outcomes. The use of a stabilization splint allows condylar repositioning into minimizing parafunctional muscle activity and protecting joint structures. In cases of ongoing condylar resorption, splint therapy should precede treatment until remodeling stability is confirmed, with continued monitoring during and after orthodontic care. Recent advances in three-dimensional image technology enable accurate assessment of condylar morphology and position. Integration of cone-beam computed tomography-based virtual articulators and digitally fabricated splints provides clinicians with enhanced tools to diagnose and manage anterior open bite from a TMJ-centered perspective. This approach offers a more predictable and biologically sound pathway to long-term occlusal and joint stability.

DOI

10.1053/j.sodo.2025.07.009

Publication Date

1-1-2025

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