Thank you for your compliments and your interest in our case report, “Lateral open bite: treatment and stability” (Am J Orthod Dentofacial Orthop 2010;137:701-11). We are glad that you agree that extrusion of teeth for this patient was the best treatment option, and that tongue thrusting was most likely the etiologic factor of this malocclusion. Therefore, to increase stability, myofunctional therapy was indicated and performed after orthodontic treatment. The functional exercises were not exactly those suggested by Alexander (Alexander RG. The role of occlusal forces in open-bite treatment. J Clin Orthod 2000;34:23-9) but perhaps similar. Because the patient had muscle tonus and mobility problems, exercises of isometric and isotonic contractions were prescribed, associated with the work of correcting the proprioceptive positioning of the tongue. Evidently, other retention methods could have been used, including a Hawley plate with tongue cribs, but in association with myofunctional therapy, which seemed to be the most important for this patient. Shielding could also have been used during treatment in association with vertical elastics, which are primarily responsible for closing the open bite. Again, thank you for your positive comments.
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