Anterior Open Bite — ORE Part 1 MCQ

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HardOrthodonticsAnterior Open BiteORE Part 1

A 16-year-old patient presents with an anterior open bite and a tongue thrust habit. Lateral cephalometric analysis shows an increased lower anterior face height and a steep mandibular plane angle. What is the most likely skeletal pattern contributing to this malocclusion?

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Correct answer: A — Increased vertical skeletal pattern (high angle/long face)

Explanation lettering: C = shown as B · E = shown as C · B = shown as D · D = shown as E

The combination of increased lower anterior face height and steep mandibular plane angle is diagnostic of an increased vertical skeletal pattern (high-angle, hyperdivergent, or long-face phenotype). This represents excessive vertical growth of the maxilla and/or mandible with posterior rotation of the mandible, creating predisposition to anterior open bite. While anterior open bite can occur alongside any anteroposterior skeletal pattern (Class I, II, or III equally), the vertical dimension is the primary skeletal contributor in this case. The tongue thrust habit may be both a cause and consequence of the skeletal vertical pattern. Options B and C describe anteroposterior relationships unrelated to the vertical findings. Options D and E are contradicted by the documented cephalometric evidence of increased vertical dimensions.

Reference: Vertical Control of a Severe Hyperdivergent Skeletal Class II Malocclusion with Steep Posterior Occlusal Plane in a Camouflage Case. PMC9502811. Long face syndrome characterized by excessive vertical growth, increased lower face height, and open bite tendency. 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9502811/