Use of a modified vertical holding appliance for open bite interceptive treatment in growing patients

Background The aim of this paper is to illustrate the use of a modified vertical holding appliance (G-VHA) to obtain the vertical control of maxillary molars and tongue stimulation in order to achieve a transverse activation in growing patients with dental open bite without the patient's compliance.Case reports The G-VHA is a modified trans-palatal bar with a resin pad covering the Omega central loop and two adjunctive lateral loops to ensure the bar flexibility. The G-VHA is designed to direct the force of the tongue against the upper molars to generate intrusion and at the same time to stimulate and re-educate the tongue. Two cases of dental open bite in growing patients are illustrated. Both patients were successfully treated, and the open bite was fully corrected thanks to molar intrusion, following counterclockwise rotation of the mandible and tongue correction. Finishing of alignment was performed in phase II of the treatment with conventional appliances.Conclusion The G-VHA proved to be effective in controlling the vertical position of maxillary molars promoting the counter-clockwise rotation of the mandible and stimulating a different tongue posture.