Correction Of Deep Bite Research Articles

Clinical effects with customized brackets and CAD/CAM technology: a prospective controlled study

ObjectiveNowadays, CAD/CAM technologies enrich orthodontics in several ways. While they are commonly used for diagnoses and treatment planning, they can also be applied to create individualized bracket systems. The purpose of this prospective quasi-randomized study was to evaluate the clinical efficiency of a customized bracket system and its comparison with directly bonded conventional self-ligating bracket treatment.Materials and methodsAltogether 38 patients were separated into two groups, treated either with direct bonded self-ligating brackets (Damon, Ormco, USA) or with indirect bonded customized CAD/CAM brackets (Insignia™, Ormco, USA). Overall treatment time, number of treatment appointments, number of lost or repositioned brackets, number of arch wires and wire bends, Little Irregularity Index, cephalometric analyses and ABO scores were compared. Superimpositions of the virtual set-ups and the treatment results of the CAD/CAM group were performed to evaluate the clinical realization of the treatment planning.ResultsNo differences between both treatment groups were found concerning overall treatment time, number of appointments and number of archwire bends. Bonding failures occurred more often using the CAD/CAM system. Indirectly bonded brackets did not have to be repositioned as often as directly bonded brackets. Treatment results with both systems were similar concerning their effects on the reduction of ABO scores. The number of used archwires was higher in the CAD/CAM group. Treatment with both systems led to further proclination of the incisors. Proclination in the lower jaw was greater than proclination in the upper jaw, and there was a statistically significant difference between the two treatment systems. Comparing the treatment results with the virtual set-ups, mesial positions were met best, followed by vertical positions. Transversal positions showed the greatest discrepancies. Concerning angles, values of angulation showed greatest accordance to the virtual set-up, while values of inclinations showed greatest discrepancies.ConclusionIn comparison with a direct bonded self-ligating bracket system the use of indirect bonded customized CAD/CAM brackets showed only minor influence on treatment efficiency and treatment outcomes. Transversal expansion, deep bite correction, expression of torque and anchorage loss remain challenges in the treatment with straight-wire appliances.Trial registration DRKS, DRKS00024350. Registered 15 February 2021, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024350.

Invisalign eighth-generation features for deep-bite correction and posterior arch expansion

Invisalign eighth-generation features for deep-bite correction and posterior arch expansion

Precision bite ramps and aligners: An elective choice for deep bite treatment.

To review a series of clinical studies demonstrating the clinical efficiency of aligners with bite ramps in the treatment of severe deep bite. In order to predictably manage the correction of deep bite with aligners, precision bite ramps on maxillary incisors have been used while posterior extrusion and anterior intrusion in the lower jaw with lateral attachments and proper levelling of the curve of Spee have been planned. Transverse correction and controlled upper and lower incisors proclination completed the treatment plan. Full deep bite correction with normal overbite was obtained in nine months of treatment by a combination of anterior intrusion and posterior torque correction, distal tipping and relative extrusion. The use of bite ramps represents a valid option for the successful treatment of deep bite with aligners creating proper space for lateral sector extrusion and supporting lower anterior intrusion and controlled proclination.

Computation of optimum parameters to achieve the intrusion of mandibular central incisor and mandibular canine for deep bite treatment

Deep bite is a condition in which the maxillary and mandibular arch of teeth overlap with each other. Mandibular central incisor and mandibular canine are extruded significantly in this case. Hence, they need to intrude apically. The segmented arch technique is more effective than any other method for the correction of deep bite. However, there is no significant research to use a segmented arch technique in lingual orthodontics. Hence, the aim of the present research study is to specify accurate tilt (toe) angles in lingual orthodontics (LiO) required for intrusion of the mandibular central incisor and mandibular canine tooth for different positions from respective occlusal plane and to state comparative assessment of required tilt angles for both the teeth. For this purpose, single intrusive force was considered to act from top surface of a lingual bracket of the mandibular tooth. The position of application of intrusive force was considered from two factors, i.e. horizontal distance of bracket top surface from tooth surface and vertical distance of bracket top surface from an occlusal plane. In the present study, four different values of vertical distance of bracket top surface from an occlusal plane were considered. Thus, four different positions of application of intrusive force were considered for both the teeth (mandibular central incisor and mandibular canine). Required (optimum) tilt angles were computed mathematically for each tooth to pass the intrusive force vector through Cres. It is then verified with finite element analysis of CAD models of tooth assemblies. For the mandibular central incisor, the tilt angle was found to be 0° for vertical distance of 3 mm from an occlusal plane (OP). While, for mandibular canine, the tilt angle was found to be 0° for vertical distance of 2 mm from an occlusal plane (OP). Hence, these positions of point of application of intrusive force can be considered as better positions than others clinically.

MYOFUNCTIONAL THERAPY IN ANTERIOR DEEP BITE AND TMD PATIENT-CASE REPORT

Deep bite is perhaps one of the most common dental malocclusions seen in children as well as in adults and is very demanding to be treated successfully. A skeletal or dental overbite is caused by genetic or environmental factors, or a combination of both. The ideal overbite in a normal occlusion may range from 2 to 4 mm. Mild deep bite typically requires no correction, unless correction for aesthetic reasons. Severe overbite, considered as a clinical problem may affect the temporomandibular joint, causes periodontal problems and tooth wearing, as well as traumatizing the incisive papilla or interfering with mastication function. Anterior deep bite could be caused by overeruption of upper and/or lower incisors or undereruption of posterior teeth. Correction of deep overbite has always been challenging to orthodontists, especially in adult cases. There are different modalities in orthodontic treatment of this malocclusion. Deep bite correction can be treated with intrusion of incisors, extrusion of posterior teeth, combination of both, and orthognathic surgical modality. The aim of this case report was to present treatment protocol for an adult patient with skeletal deep bite, Class II Division 1 malocclusion and temporomandibular disorder (TMD) managed with conventional orthodontics therapy combined with orofacial myofunctional exercises. The modality of exercise therapy included improvement of proprioception, tonicity and mobility, working with the facial and cervical musculature, as well as with stomatognathic functions - respiration, mastication, deglutition and speech. The most important thing is to aid long-term retention. Keywords: anterior deep bite, TMD, myofunctional therapy.

Mechanical considerations for deep-bite correction with aligners

Correction of deep-bite malocclusions with aligners is challenging for orthodontists. This review is intended to help orthodontists improve their clinical success in treating deep-bite malocclusions with aligners. Virtual case setup, attachment design, elastics, and bite ramp utilization are discussed in order to better equip orthodontists with a new “best practices” paradigm.

Study of the Stress Distribution Around the Mini-implant During Maxillary Anterior Intrusion Under Different Conditions: A 3-Dimensional Finite Element Analysis

Introduction: Correction of deep bite is one of the major challenges of orthodontic treatment. Mini-implants provide stable intra-oral anchorage and facilitate the maxillary incisors to be intruded without the usual side. The purpose of this finite element study was to evaluate the stress distribution around the mini-implant during maxillary anterior intrusion under different conditions of different angulations and different positions of implant. Material and Methods: Finite element analysis was carried out. Stress under the following 4 conditions was analyzed: (a) single central implant placed at 90°, (b) single central implant placed at 120°, (c) bilaterally placed implant at 90°, and (d) bilaterally placed implant at 120°. Results: The displacement seen with 90° angulation in the single implant case is less compared with the 120° angulation case for all the 6 maxillary anterior teeth. Also, in the bilateral implant case, the Von Mises stress is less when the 90° angulation case is compared to 120° angulation case. But in bilaterally placed implant, the stress gets distributed evenly in the anterior region. The stress in 90° angulation cases seems to be concentrated at the center. Conclusion: Stresses measured on the teeth are less and distributed more evenly when the point of force application is bilateral. It was also observed that the stress increases with increase in the angulation of the implant. As the contact between the implant and the bone increases, the stability increases. Hence, the implant should be obliquely inserted into the bone. Concentrated stresses are not favorable as they can increase the risk of bone and root resorption.

Deep bite correction with an anterior bite plate in a growing patient

Background: Deep bites represent one of the most difficult cases in orthodontic treatment. In growing patients, strategies for deep bite correction include extrusion of posterior teeth and intrusion of incisors, which can be achieved using anterior bite plates. This case report presents the treatment of a deep bite in a growing patient using an anterior bite plate. Case Report: A 13-year-old female presented with a convex profile, short lower facial height, a Class II skeletal relationship, a deep bite (6 mm overbite), a 6 mm overjet, and severe crowding on both arches. The patient was treated with a removable anterior bite plate in conjunction with a fixed appliance. A normal overbite (2 mm) was achieved, severe crowding was corrected on both arches, the lower facial height was increased, the interincisal angle remained favorable, the mandibular incisors were well positioned in the basal bone, and the smile esthetics improved. Conclusion: The use of an anterior bite plate in combination with fixed appliances is effective in treating deep bites in a growing patient.

Effectiveness of miniscrew-supported maxillary incisor intrusion in deep-bite correction: A systematic review and meta-analysis.

To evaluate systematically the effectiveness of miniscrew-supported maxillary incisor intrusion compared with other nonsurgical intrusive mechanics for deep-bite correction. Unrestricted electronic searches in Embase, Web of Science, MEDLINE, LILACS, and Cochrane's CENTRAL as well as manual searches were conducted up to August 2019. Only randomized clinical trials (RCTs) were included. Study selection, data extraction, and bias assessment were done by two independent reviewers. The Cochrane risk-of-bias tool was used, and the quality of evidence was graded using the GRADE approach. A random-effects meta-analysis of continuous data, with its 95% confidence intervals (CIs), was used. Seven RCTs were included in the quantitative synthesis, and the overall quality of evidence was very low to low. When compared with intrusion arches, miniscrews resulted in a more efficient deep-bite reduction with a standardized mean difference (SMD) of -0.48 (95% CI, -0.89 to -0.07). When miniscrews were used, a statistically significant difference was observed favoring less maxillary molar extrusion (SMD, -0.86; 95% CI, -1.46 to -0.27) and more incisor intrusion as measured from centroid to palatal plane (SMD, -0.95; 95% CI, -1.41 to -0.49). Results also showed a statistically nonsignificant difference regarding the amount of resultant root resorption between miniscrews and intrusion arches. There is weak evidence indicating efficient deep-bite correction using miniscrews. Root resorption seems to be an associated adverse effect that occurs regardless of the intrusive mechanics used. These conclusions should be viewed with great caution as further well-designed long-term research is recommended.

Forward Mandibular Growth after Correction of Deep Bite in Growing Patient with Skeletal Class II

Forward Mandibular Growth after Correction of Deep Bite in Growing Patient with Skeletal Class II

Intrusive Arch versus Miniscrew-Supported Intrusion for Deep Bite Correction.

BACKGROUND:Intrusion of maxillary incisors is the treatment of choice to correct deep bite problem in gummy smile patients.AIM:The objective of this study was to compare the effectiveness and efficiency of miniscrew-supported intrusion versus intrusion arch for treatment of deep bite.METHODS:The study sample consisted of 30 post pubertal patients (21 females and 9 males) with an age range from 17 to 29. They were divided into 2 groups (15 subjects in each group). Group 1 underwent maxillary incisor intrusion using miniscrews, and in group 2 intrusive arch was used. Pre and post-treatment lateral cephalometric x-rays and study models were made to evaluate the demo-skeletal effects. During the study period, no other intervention was attempted. Paired t-test was used to study the changes after treatment.RESULTS:The mean amount of overbite correction was 2.6 ± 0.8 (0.49 mm per month) in the miniscrew-supported intrusion group and 2.9 ± 0.8 (0.60 mm per month) in the intrusive arch group. No statistically significant difference was found in the extent of maxillary incisor intrusion between the two systems. The two intrusion systems were statistically different in the extent of incisor proclination, as an intrusive arch group tended to proline upper incisors more than miniscrews-supported intrusion group.CONCLUSION:Both systems successfully intruded the 4 maxillary incisors almost with no loss to the sagittal and vertical anchorage, although intrusive arch tended to proline upper incisors significantly.

Long-term stability and relapse of deep bite correction:a systematic review

Deep overbite is one of the most common malocclusions and is the most difficult to treat successfully. The real challenge remains the stability of long-term deep overbite correction. A search through the scientific literature revealed only one systematic review on this subject. Given the recent publications on the stability of deep bite correction and the development of new processes designed to avoid relapse of these treatments, this one existing systematic review needs to be updated. The purpose of the present systematic review is to evaluate the long-term stability of deep overbite correction. Electronic databases were searched and nonelectronic journals were manually explored for papers on long-term stability and relapse of deep overbite correction. Articles deemed appropriate for inclusion in this review were selected and analyzed. Their scientific quality was assessed and the data they contained were extracted and summarized. The rate of deep overbite relapse was 47.27%. Patients treated with the straight wire appliance showed a 67.74% relapse rate whereas those treated with the Ricketts biological progressive segmented mechanics appliance displayed a 30.38% rate. Subjects treated towards the end of adolescence presented a 14.3% rate of deep overbite relapse whereas those treated in their early teens or in adulthood had a deep overbite relapse rate of 30% and 30.8%, respectively. Intramuscular injections of botox helped obtain 100% stability in maxillofacial surgery to correct deep bite. Age at initiation of treatment and treatment technique are two factors impacting the long-term stability of deep overbite correction.

EFEK DENTOSKELETAL PADA MALOKLUSI KELAS II DIVISI 1 DENGAN BIONATOR DAN ALAT ORTODONTI LEPASAN : LAPORAN KASUS

Background: Class II division 1 malocclusion characterized by mandibularretrognation, deep bite and increasement of overjet. Myofunctional appliance could modify the growth and developmental of mandibular at appropriate phase. The purpose of this case report was to present successful management of Class II division 1 by using bionator and removable appliance.Case Management: A 9 years old girl with upper teeth protrusion, crowding and affected the esthetical perception. The diagnosis was Class II division 1 with mandibular retrognation and upper incisor protrusion, upper and lower anterior crowding and palatal bite. Patient also had lip biting and thumb sucking habit. Bionator leads the mandibular moved forward and arch widening. Treatment planning were to reduce overjet by prognating mandibular and bad habit elimination. Followed by retracting the upper teeth and deep bite correction by using removable appliance.Conclusion: Patient profile became corrected in 10 weeks. Overjet reduced in by prognating the mandible, decreasing of palatal bite, molar relation become Class I and bad habit elimination. In 10 months, overjet and overbite were corrected.

Preprosthetic Orthodontic Treatment of Deep Bite with Congenitally Missing Mandibular Central Incisors

The objective of a preprosthetic orthodontic treatment is to position the teeth in such a way that a treatment with (fixed) dental prostheses is made possible or simplified or to affect the result of this treatment positively. For deep bite cases with agenesis and/or early loss of teeth, a treatment with either fixed dental prostheses is usually indicated after correction of anterior deep bite. This helps to achieve sufficient clearance for fabrication of fixed prosthesis. This is a case report of an 18-year-old female patient referred for preprosthetic orthodontic treatment. She had Class I malocclusion with deep bite and congenitally missing mandibular central incisors (Figure 1). Bonding of both arches was done with 022 MBT bracket systems. In this case intrusion of maxillary anterior teeth was achieved with mini screw implants (1.2 × 6 mm) placed between lateral incisors and canines bilaterally for 7 months. Open niti coil spring on 19 × 25 SS was placed to restore the space for the missing incisors in lower arch Case was debonded once sufficient clearance was achieved for the fabrication of prosthesis. Total treatment time was 12 months (Figures 2 and 3). Correction of deep bite with 5 mm of true intrusion was achieved and the FPD was bonded successfully.

Force changes associated with different intrusion strategies for deep-bite correction by clear aligners.

To investigate the relationships among different intrusion patterns of clear overlay aligners and the corresponding orthodontic forces and to provide guidance for clinical treatment. Five sets of removable thermoplastic-formed aligners with the same thickness, designed for different intrusion procedures (G0 aligners as a control group, with no activation; G1 aligners for intruding canines; G2 aligners for intruding incisors; G3 aligners for intruding canines and incisors with the same activations; G4 aligners for intruding canines and incisors with different activation), were manufactured, and the corresponding intrusion forces were measured with a multiaxis force/torque transducer measurement system in real time. With the same activation (0.2-mm intrusion) and rectangular attachments placed on the premolars and first molars, the canines experienced the largest intrusive force when intruded alone using G1 aligners. The canines received a larger intrusive force than incisors in G3. The incisors received similar forces in G2 and G3. First premolars endured the largest extrusive forces when all anterior teeth were intruded with G3 aligners. Extrusion forces were exerted on canines and lateral incisors when using G4 aligners. Aligners with different intrusion patterns exert different forces on incisors, canines, and premolars, and the forces were closely related to the designed activation, shape and position of the attachment and relative movement of the adjacent teeth.

Button Bite Turbo

Deep overbite or deep bite is a common malocclusion. The etiology may be dental, skeletal, or combination of both skeletal and dental. The treatment plan to correct deep overbite depends on the severity, type and the age of the patient. In deep bite with redundant upper and/or lower lips, or no interlabial gap, posterior extrusive mechanics may be desirable (if other considerations pearmit). Extrusion mechanics are considered if there is adequate interocclusal space. The bite turbo appliance discussed in this article permits disocclusion of the posterior teeth which allows extrusion of the premolar and molars leading to correction of deep bite.

The Effect of Anterior Bite Plate on Deep Bite Correction During Early Mixed Dentition

Background: Deep bite is one of the main common occlusal discrepancies of mixed dentition period and anterior bite plate is recommended in early mixed dentition to correct the trait and prevent the future malocclusion. The aim of this study was to assess the effect of anterior bite plate on the correction of deep bite in early mixed dentition. Methods: This retrospective semi-experimental clinical trial was conducted on 16 patients (8 males, 8 females) with deep bite and class II malocclusion in early mixed dentition. Cephalometric radiographs were obtained from patients’ records before and after the application of anterior bite plate. Changes in 11 various angular, ratio and distance measures were evaluated by tracing the cephalograms. Collected data were then analyzed using paired t-test. Results: Statistical differences were evaluated before and after the use of anterior bite plate appliance. Change in overbite, overjet, ANB angulation, anterior facial height, posterior facial height and Jarabak index were calculated with results indicative of significant changes (P 0.914, P > 0.219, P > 0.753, P > 0.276, P > 0.062). Conclusions: Treatment with the anterior bite plate was shown to be effective in correction of the deep bite in cases with class II malocclusion with little need for complex fixed appliance therapy.

Class II deep bite correction with herbst appliance assisted with mini screws

This case report describes the orthodontic treatment of a 36-year-old female with Class II Division 1 malocclusion associated with deep overbite. The treatment was based on nonextraction therapy using MBT: McLaughlin, Bennett and Trevesi. Orthodontic bracket system slot 0.022 straight-wire appliance. Deep bite correction was assisted with labial mini screws. A Herbst appliance with Class II elastics was used for canine and molar Class II correction and overjet reduction. Treatment goals were achieved in 22 months, and the results included a normal overjet, Class I occlusion, competent lips, and an acceptable facial profile.

A comparative evaluation of bite opening by temporary anchorage devices and Connecticut intrusion arch: An in vivo study

Introduction: Deep bite correction in patients with convex profile and increased maxillary incisor visibility, and normal or increased vertical dimension necessitates the intrusion of maxillary incisors. Intrusion arches or miniscrews are commonly used for this purpose. The current study compares one of the prefabricated intrusion arches, the Connecticut intrusion arch (CIA), and the temporary anchorage devices (TADs) in their effectiveness for orthodontic intrusion. Materials and Methods: The present prospective study was done on 24 patients in the age group of 15–25 years undergoing fixed orthodontic treatment. In Group I, TADs were placed for intrusion while, in Group II, CIA was placed. Anchorage was reinforced in Group II using transpalatal arch. A paired t-test or a Wilcoxon signed-rank test was performed for the assessment of treatment changes within the groups, and an independent t-test or a Mann–Whitney U-test evaluated change between the groups. Results: Both TADs and CIA can bring about significant amount of true incisor intrusion with resultant decrease in incisor visibility. However, in the TAD group, in addition to intrusion, the incisors also proclined by 0.67 mm, but in CIA group, incisors retracted by 0.33 mm. There were nonsignificant mesial drift and significant extrusive movement of the maxillary first molars in the CIA group. The rate and amount of intrusion was greater in the TAD group. Conclusions: Both TADs and CIA can be effectively used for incisor intrusion which was, however, faster and greater in TAD group. Both the methods bring about associated unwanted tooth movements as well.

Efficacy of Anterior Bite Plane in Class II Deep Bite Case - A Case Report

Abstract Aims and Objectives: Deep bite is one of the common malocclusion which has a varied of etiologies; this case report includes correction of deep bite with help of anterior bite plane. Materials and Methods: One post pubertal patient of age 15 years with proclined maxillary incisors with class II skeletal and class II molar treated with fixed orthodontic appliance with anterior bite plane. Results: It resulted in favorable skeletal and dentoalveolar changes. Midlines were coinciding, molars were in class I relationship and smile was improved. Conclusion: Using anterior bite plane corrected class II deep bite in patient, corrected lip trap and proclined maxillary incisors.