Closure of Open Bites With Orthognathic Surgery—No Segmentalization

Patients with anterior open bite (apertognathia) generally have significant functional disability with speech articulation and masticatory insufficiency. When facial skeletal dysmorphia is the etiology, orthognathic surgery is the cure. There have been multiple treatment schemes described by many clinicians, including segmental maxillary procedures, mandibular procedures, performed both in the ramus and segmental procedures, and the Le Fort I osteotomy. Treatment options and decisions must take into account risk and expected outcome as well as etiology of the dysmorphia, including idiopathiccondylar resorption. Le Fort I osteotomy without segmentalization (beyond a midline osteotomy for transverse expansion) can be employed in the great majority of presentations to provide resolution of the disability. Close communication with the orthodontist providing the leveling and aligning is critical to provide the expected outcome.