does not have a normal incisor show at rest and smile, then anterior extrusion may be done in these patients. high-pull headgear this appliance can be used with patients who are growing and in permanent dentition. this appliance has been advocated to be used mainly for controlling the vertical dimension by applying force to intrude molars. elastics elastics have been used to correct anterior dental open bite. these elastics can be in configuration of triangular or anterior vertical elastics. bite blocks r. kuster and b. ingerval in 1992, used two types of bite blocks to evaluate their effect on skeletal open bite patients. one group of patients had spring-loaded bite block for one year and other group had repelling magnets as bite blocks for 3 months. both type of bite blocks exerted intrusive force on both upper and lower posterior teeth. they saw 3mm improvement in overbite with magnet group and 1.3mm improvement in overbite with spring-loaded group. they concluded that this effect resulted due to counter-clockwise rotation of mandible which was caused by intrusion of posterior teeth and increased eruption of incisors. glossectomy there are not systematic reviews or randomized clinical control trials related to correction of open bite with partial tongue glossectomy but several case reports have been published indicating successful treatment of open bite with this surgical approach. macroglossia has been reported to cause open bite and bimaxillary protrusion and is also known to be make orthodontic treatment unstable after its completion. orthognathic surgery an orthognathic surgical approach can be taken to correct an open bite once vertical growth has finished in male and female patients. at that time, a le-fort i osteotomy to impact the maxilla is usually done. according to proffit et al., surgical movement that involves maxillary impaction is the most stable surgical movement in the hierarchy they established. a two jaw surgery can also be performed where bilateral sagittal split osteotomy can be done to correct any antero-posterior changes of the mandible. however, with two jaw surgery a relapse leading to bite opening may happen due to condylar remodeling and resorption. stability and relapse surgery vs. non-surgery geoffrey greenlee and others published a meta-analysis in 2011 which concluded that patients with orthognathic surgical correction of open bite had 82% stability in comparison to non-surgical correction of open bite which had 75% of stability after 1or more year of treatment. both the groups started with 2–3 mm of open bite initially. molar intrusion man-suk baek and others evaluated long-term stability of anterior open bite by intrusion of maxillary posterior teeth. their results showed that the molars were intruded by 2.39 mm during treatment and relapsed back by 0.45 mm or 22.8%. the incisal overbite increased by 5.56 mm during treatment and relapsed back by 1.20 mm or 17%. they concluded that majority of the relapse occurred during first year of treatment.