Figure 24.

Excessive granulation tissue reaction around Otten hooks and elastic loops applied for closed treatment of a subcondylar fracture on the right. A partial acrylic plate was placed in the first quadrant to provide a posterior fulcrum intended for reduction of the condylar fragment. The functional consequence is a circular open bite. The upper central incisors have been protruded and rotated inward by the elastic bands “cutting” into the gums and the interdental spaces thus lifting the teeth forward.