Vertical segmental anterior mandibular distraction to aid closure of a severe anterior open bite associated with an accentuated reverse curve of Spee

BACKGROUND: The correction of severe anterior open bite is technically challenging, often requiring the use of complex orthodontic mechanics and/or orthognathic surgery and has a relatively high risk of relapse. A marked reverse curve of Spee in the lower arch presents additional challenges when correcting a severe anterior open bite. METHODS AND MATERIALS: A 22.2-year-old Caucasian man presented with concerns relating to poor anterior occlusion associated with a 1.3-cm anterior open bite. There was an accentuated reverse curve of Spee to the lower arch, an increased maxillary-mandibular plane angle and increased lower face height. Multidisciplinary treatment involving the use of segmental anterior mandibular distraction to level the curve of Spee before undertaking a Le Fort I posterior maxillary impaction is described in this case report. RESULTS: Long-term post-treatment records showed stable anterior open bite correction. CONCLUSIONS: This case report illustrates the successful use of segmental anterior mandibular vertical distraction followed by conventional Le Fort I posterior impaction surgery to correct a severe anterior open bite associated with an accentuated reverse curve of Spee and high maxillary-mandibular plane angle.