Clear Aligner Therapy Assisted by Implant Anchorage and S-Shaped Root Control Attachments for Anterior Open Bite Correction: A 30-Month Treatment Case Report.

Anterior open bite is a prevalent malocclusion that can cause occlusal dysfunction and markedly reduce masticatory efficiency. This case report describes the successful management of a 37-year-old female with an anterior open bite secondary to excessive vertical development in the molar region and clockwise mandibular rotation. The treatment combined clear aligners with implant anchorage for molar intrusion, alongside S-shaped double-arm root control attachments to facilitate the uprighting of severely tilted teeth. Following the placement of four implants in the maxillary posterior region, the therapy was systematically carried out in four distinct phases: molar intrusion, premolar intrusion, correction of mandibular anterior tooth axial inclination, and final occlusal refinement. After 30 months, both the occlusal relationship and facial profile were significantly improved, with complete resolution of the anterior open bite and establishment of normal overbite and overjet. Cephalometric analysis confirmed favorable outcomes, including counterclockwise rotation of the mandible. This case highlights the efficacy of an implant-assisted clear aligner protocol augmented by specialized attachments for managing complex anterior open bite, thereby expanding the scope of clear aligner therapy.