Dentoskeletal morphology in Class I and Class II malocclusion with increased overbite

Abstract

It was a great pleasure to read the article titled, “Dentoskeletal morphology in adults with Class I, Class II Division 1, or Class II Division 2 malocclusion with increased overbite” (Uzuner FD, Aslan BI, Dinçer M. Am J Orthod Dentofacial Orthop 2019;156:248-56). The authors have mentioned that overbite was measured as the distance between the incisal tips of the mandibular and maxillary central incisors perpendicular to the occlusal plane. The authors have nowhere mentioned about the use of casts in this study. If the overbite was measured using only lateral cephalograms, as it seems to be, the accuracy of the measured values becomes questionable. If casts were available, the authors could have evaluated the effect of tooth size-arch length discrepancies, Bolton discrepancies, macrodontia, and microdontia on the overbite as part of the dental morphology. The study was carried out using lateral cephalograms, which are 2-dimensional images, and the authors have concluded that an increased overbite may occur in different craniofacial patterns and fail to demonstrate a characteristic craniofacial morphology. However, with lateral cephalograms, transverse dimension cannot be ascertained. It is possible that discrepancies in the transverse dimensions may be the root cause of an increased overbite. For example, narrow arches may lead to crowding in the maxillary or mandibular arches or both and a possible increase in overbite as a consequence. Their conclusion, in which the authors have mentioned that the sagittal position of both jaws did not have any influence on the amount of overbite, seems to be inappropriate. The authors evaluated adult patients who were in cervical stage 6, which means the outcome of sagittal discrepancies between the jaws has already occurred. When there is sagittal discrepancy between the maxilla and mandible, as in case of Class II Division 1, a lack of stable incisor contact causes extrusion of the incisors, which contributes to an increase in overbite gradually during the growth period. It would have been appropriate to mention that irrespective of the sagittal position of both jaws, overbites of various extent were observed. The authors' conclusions that lower incisor intrusion seems to be the main treatment concept in Class II Division 1 malocclusion should be clinically decided only after overall evaluation of the patient, particularly, the maxillary incisor visibility in rest position and smile, upper lip length, and presence or absence of gummy smile. Dentoskeletal morphology in adults with Class I, Class II Division 1, or Class II Division 2 malocclusion with increased overbiteAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 156Issue 2PreviewThe treatment options for adults with increased overbite are limited to dentoalveolar changes that camouflage the condition. Because of high relapse tendency, defining the problem area is important when creating a treatment plan. This study aimed to evaluate dentoskeletal morphology in skeletal Class I and II anomalies associated with Angle Class I, Class II Division 1 (Class II/1), and Class II Division 2 (Class II/2) malocclusions with increased overbite compared with normal occlusion. Full-Text PDF Authors' responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 156Issue 6PreviewWe thank Dr Karthickeyan for his interest in our article, and we would like to clarify some of his concerns with the methodology and conclusions. Full-Text PDF