Severe anterior open bite malocclusion with multiple odontoma treated by C-lingual retractor and horseshoe mechanics

A fixed lever arm appliance called C-lingual retractor was placed on the lingual aspects of the maxillary anterior teeth in a 16-year-old male patient with a Class II anterior open bite malocclusion. The treatment plan consisted of extracting both upper first premolars and retracting the upper six anterior teeth. A multiple odontoma between the lower left lateral incisor and canine was surgically removed before orthodontic treatment, and a horseshoe appliance was used in the lower dentition for intermaxillary anchorage during the bone-healing period. The transpalatal arches soldered to the upper first and second molar bands were used as an intra-arch anchor unit for upper-space closure. Class II elastics were used buccally between the upper six anterior teeth and the lower horseshoe appliance. We took 13 months to treat the open bite malocclusion. There was a decrease in lip fullness as the upper anterior teeth were retracted, which contributed to a decrease in facial convexity. The treatment result was maintained six months after debonding. Details of the new appliance, clinical procedures, and treatment changes are presented.