Nonsurgical Treatment Of Open Bite With Periodontally Accelerated Osteogenic Orthodontics

This case report presents a multidisciplinary treatment approach for managing a complex adult malocclusion involving periodontally accelerated osteogenic orthodontics (PAOO) integrated with autologous platelet-rich fibrin (PRF) and myofunctional therapy. A 22-year-old female patient Clinical examination revealed a 3.0 mm anterior open bite, Class II molar and canine relationships on the right, Class III canine relationships on the left, unilateral posterior crossbite and missing left mandibular first molar. The radiographic analysis confirmed a Class I skeletal pattern with hyper-divergent growth, prominent mandibular anterior roots, and buccal bone deficiency. The treatment plan incorporated three key components: PAOO with PRF for alveolar augmentation, orthodontic camouflage to correct the open bite and myofunctional therapy to address the tongue-thrust habit. Over a 28-month treatment duration, the integrated approach successfully corrected the open bite and improved facial aesthetics and long-term stability, as confirmed by 18-month follow-up evaluations. PAOO with PRF proved effective for augmenting alveolar bone and facilitating tooth movement while minimizing dehiscence and fenestration risks. PRF enhanced wound healing and bone regeneration, contributing to treatment stability. Myofunctional therapy successfully corrected the tongue-thrust habit, which is often associated with open bite malocclusion and can compromise long-term stability. This case underscores the importance of a multidisciplinary approach in managing complex malocclusions. The integration of orthodontic treatment with PAOO and PRF represents a novel strategy for adult patients with thin biotypes and buccal bone deficiencies.