Treatment and retention of relapsed anterior open-bite with low tongue posture and tongue-tie: A 10-year follow-up.

Abstract

The purpose of the current report is to present 6-year long-term stability and

10-year follow-up data for an adult patient who was treated with a tongue

elevator for relapsed anterior open-bite. The 19-year-old male patient presented

with the chief complaint of difficulty in chewing his food. Collectively,

clinical and radiographic examinations revealed an anterior open-bite, low tongue

posture, and tongue-tie. The patient opted for orthodontic treatment alone,

without any surgical procedure. A lingual frenectomy was recommended to avoid the

risk of relapse, but the patient declined because he was not experiencing tongue

discomfort. Initial treatment of the anterior open-bite with molar intrusion and

tongue exercises was successful, but relapse occurred during the retention

period. A tongue elevator was used for retreatment, because the approach was

minimally invasive and suited the patient's requirements regarding discomfort,

cost, and time. The appliance changed the tongue posture and generated an altered

tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a

subsequent counterclockwise rotation of the mandible. The results showed

long-term stability and were maintained for six years through continual use of

the tongue elevator. The results of this case indicated that a tongue elevator

could be used not only as an alternative treatment for open-bite, but also as an

active retainer.