Deep Overbite Research Articles

Prevalence of malocclusion in Africa: A systematic review and meta-analysis

Objective: Data available on prevalence of malocclusions are mostly local or national-based, therefore this study aimed to pool data to determine the distribution of malocclusion traits in the permanent dentition across the African continent. Methods: Recent studies published between 1990 and 2021 in PubMed, AJOL, PMC and Scopus on malocclusion prevalence in permanent dentition were reviewed. The methodological quality of the included studies was assessed using STROBE criteria. Results: Out of 82,474 retrieved studies, 11 were included. In permanent dentition, the African prevalence of malocclusion was 76.1% (45 – 95.6%). The distributions of Class I, Class II, and Class III malocclusion were 76.7% [50–96%], 9.7% [1.6–25.4%] and 4.0% [1–12%], respectively. Regarding vertical malocclusions, the observed deep overbite and open bite were 10.9% and 6.5%, respectively. Crossbites affected 9.8% of the sample. Conclusion: In Africa, Angle Class I malocclusion is more prevalent in permanent dentition, the least prevalent was Class III. This information should advice policymakers, dentists, and orthodontists across Africa on policies and clinical strategies on prevention of malocclusion.

Predictability of overbite control with the Invisalign appliance comparing SmartTrack with precision bite ramps to EX30

Although the Invisalign appliance has reported difficulty in achieving the overbite outcomes predicted by ClinCheck software (Align Technology, Santa Clara, Calif), the effect of modifications to the material and components of the appliance are largely unquantified. This study aimed to investigate and determine the accuracy of Invisalign in correcting a deep overbite by comparing the predicted outcome from ClinCheck to the achieved posttreatment outcome for treatment groups that use different components of the appliance system. A retrospective study was conducted using pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 2 groups of consecutively treated adult patients from private specialist orthodontic practices, 1 group treated with EX30 material with no bite ramps (n= 29) and 1 treated with the newer SmartTrack material and precision bite ramps (n= 39). Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners using a 2-weekly aligner change protocol. Geomagic Control X software (3D Systems, Rock Hill, SC) was used to measure overbite in the pretreatment, posttreatment, and predicted outcome stereolithography files for each patient. Results were compared with a previously published treatment group that used SmartTrack material and no precision bite ramps. The regression coefficient analysis indicated that for both groups, the deeper the pretreatment overbite and the greater overbite reduction projected according to ClinCheck, there is a linear increase in the discrepancy of overbite expression posttreatment. ClinCheck overpredicted overbite reduction in 96.6% of patients with precision bite ramp in which, on average, 43.4% of the prescribed overbite reduction was expressed. For EX30 patients, ClinCheck overpredicted overbite reduction in 87.2% of patients in which, on average, 55.1% of the prescribed overbite reduction was expressed. The use of precision bite ramps does not appear to significantly improve the ability of SmartTrack material to predictably open the bite. SmartTrack material with or without bite ramps does not appear to produce better bite opening predictability than that seen with EX30 material.

STUDYING IN ORTHODONTAL TREATMENTS AT MIXED DENTITION STAGE USING 2X4 FIXED APPLIANCES

Using fixed appliances 2x4 in early treatment of malocclusion at mixed dentition stage will adjust the relative correlation of occlusion; which has been studied internationally. However, in Vietnam, there are few publised studies about the effective function of this appliance in treatment. We have conducted the study about the effects of using this appliances in malocclusion early treatment for 36 mixed dentition stage patients. Objective: The study aimed for evaluating the results of malocculsion early treatment using 2x4 fixed appliances. Methods: Prosspective study. Results have shown the 2x4 fixed applianes in early treatment would adjust the relative correlation of occlusion both vertically and horizontally, in which the front teeth aligned neatly, retroclined and a deep overbite conditions improved significantly and maxillary crowded anterior teeth condition was also corrected. The indexes on Cephalometric before and after treatment desmontrated well correlation in anterior-posterior plane.

Treatment of Anterior Crossbite with Skeletal Class III Malocclusion during the Growth Period

Anterior crossbite is the most common problem in Angle class III malocclusion and is aesthetically disturbing. As individuals get older, an anterior crossbite can worsen, impacting the esthetics of the face and the stomatognathic system’s function significantly and requiring immediate treatment. Due to genetics, habitual postures, ethnicity, and environmental variables, the class III malocclusion’s etiology is multifaceted. In terms of treatment, there are three options: growth modification, camouflage, and orthognathic surgical treatment. This case report aims to describe a non-surgical treatment with simple treatment mechanics in two patients who were still in their growth period. Two patients, a sibling aged 14 and 13 years, experienced an anterior crossbite with a deep overbite, diagnosed with Angle class III with skeletal class III relationships. Besides, the profile revealed a concave, with an overjet of -2mm and an overbite of 4mm. The treatments were then performed employing fixed orthodontic appliances with vertical U-loops for protraction of upper anterior teeth and class III intermaxillary elastics to correct molar relationships. The treatment was completed in two years, in which the anterior crossbite was corrected. The molar and canine relationships, which were originally class III, became class I. Loss of tooth 36 was closed, and tooth 38 has fully erupted. Treatment of anterior crossbite needed to be done as soon as possible to prevent more severe abnormalities. In conclusion, a treatment in the growth period with simple techniques resulted in significant improvements in function and aesthetics.

Occlusal deviations in adolescents with idiopathic and congenital scoliosis.

ObjectiveThis cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations.MethodsFifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test.ResultsIn comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients.ConclusionsPatients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

SIMULTANEOUS RETRACTION AND INTRUSION OF MAXILLARY ANTERIOR TEETH: A REVIEW

Simultaneous retraction and intrusion of anterior segment are required in the patients who have deep overbite along with ared incisors. During the retraction of anterior segment, there is some bite deepening, which also requires intrusion. So there are various conventional methods which are used from many last years to achieve simultaneous retraction and intrusion, but these methods require patient compliance and have some undesirable side effects like anchorage loss. With the advent in technology, Orthodontic mini-implants (OMI) broaden the scope of orthodontic therapy by allowing treatment to proceed with little or no anchoring loss and require less patient participation than traditional procedures. Mini implants can be used to offer good anchorage for anterior tooth retraction and intrusion, and they can be inserted in almost any desirable site. There are various conventional methods as well as mini implant supported methods with which simultaneous retraction and intrusion can be achieved. This review article presents the various methods for achieving simultaneous retraction and intrusion of anterior segment either with conventional techniques or with the help of mini implants.

Correction of a prominent premaxilla in a juvenile with a bilateral cleft lip and palate using a novel, hybrid function regulator, the FR-BCPPm, followed by preadjusted fixed appliances: A 20-year follow-up.

A seven-year-old boy with a repaired bilateral cleft lip and palate, presented with a severe skeletal II base and an extremely prominent premaxilla. He had grossly incompetent lips with lower lip trapping, an 18.5-mm overjet, a deep overbite, markedly retroclined lower incisors, bilateral crossbites and 12-mm-wide alveolar gaps together with 6-mm vertical steps between the extruded premaxillary incisors and the posterior teeth. Before the eruption of the permanent canines, there was an urgency to approximate the opposing cleft alveolar margins and to level the split maxillary occlusal plane, in order to facilitate the successful insertion and subsequent consolidation of secondary alveolar bone grafts.A new functional appliance was therefore designed to achieve this objective, which drew components from Fränkel's FR I and FR III function regulators. Together with a couple of novel components, it created a hybrid appliance, namely the function regulator for juveniles with a bilateral cleft and a prominent premaxilla: the FR-BCPPm.The patient was treated with this appliance and a nocturnal headgear at 7-13 years, together with a concomitant quad helix appliance followed by a transpalatal arch and bilateral bone grafts. He was then treated non-extraction up to the age of 17 years with preadjusted fixed appliances to correct his residual, crowded Class II malocclusion.The marked improvement in his occlusion, dentofacial appearance and his perioral function after a decade of treatment was then followed up over 20 years, during which time mild relapse of the incisor overjet and moderate recurrence of the lower anterior misalignment was noted two years after treatment.While no further relapse was observed at the four-year post-treatment review, by 20 years after treatment, a little further misalignment of the lower anterior teeth was noted, half of which was deemed to be attributable to age-related maturation.

Use of temporary skeletal anchorage devices for intrusive root movement of maxillary incisors in adult patients with Class II Division 2 malocclusion

• In treating adult Class II Div. 2 patients, absolute intrusion of the maxillary incisors is needed. • The combined use of TSADs enabled effective intrusion of maxillary anterior teeth. • The vertical position of the maxillary anterior teeth should be decided first for esthetic display. • An adequate maxillary occlusal plane angle should be obtained according to its incisor position. Treatment of nongrowing patients with Class II Division 2 malocclusion with a severe deep overbite is one of the most difficult cases that orthodontists can experience. Appropriate biomechanics should be applied for the intrusion of maxillary anterior teeth with these patients to avoid undesirable side effects. The vertical position of the maxillary anterior teeth needs to be decided first for esthetic incisor display, and then an adequate maxillary occlusal plane angle must be obtained accordingly, both for functional and esthetic reasons. This case report presents the biomechanics and its clinical application to treat a nongrowing patient with a severe deep overbite and retroclined maxillary incisors using multiple temporary skeletal anchorage devices.

Three-dimensional assessment of temporomandibular joint in skeletal Class I malocclusion with variable degrees of overbite and overjet

ABSTRACT Objective To three-dimensionally evaluate the position and morphology of the TMJ in skeletal Class I with variable degrees of overbite and overjet in comparison with normal peers. Methods Pretreatment CBCT scans of 126 adults were retrieved. Based on the severity of overjet and overbite, the sample was divided into three main groups and six subgroups (18 patients each): the first group with a normal overbite and variable overjet degree and the second group with normal overjet and variable overbite degree. These six subgroups were compared with a third control group of normal overjet and overbite. Results There were significant differences in vertical condylar position, vertical and anteroposterior condylar inclinations, condylar height, and significant posterior condylar positioning in severe deep overbite, compared with the control group. Conclusion There were significant changes in the TMJ components in severe deep overbite cases. Therefore, sever deep overbite could be considered a predisposing factor for temporomandibular disorders.

Determining the desired position of mini-implants in an orthodontic treatment for correction of deep overbite

• The equation to compute co-ordinates of attachment of mini-implant was formulated. • Four possible positions of mini-implant placements were considered. • Finite element analysis was carried out with an intrusive force of 50 g-force (gf). • The applied force system was verified successfully with finite element analysis. • Recommendations about feasibility of different positions of mini-implant were given. Deep overbite problem leads to gummy smile in orthodontic patients. The simultaneous intrusion of maxillary (upper) six anterior teeth with mini-implants is a common treatment method for this purpose. Till date, no study has stated desired position of attachment of mini-implant. This is an important parameter as intrusive force vector must pass through centre of resistance (C res ) of maxillary six anterior teeth. Thus, the aim of this study is to obtain the co-ordinates of desired positions of mini-implant with reference to incisal edge of first anterior tooth (maxillary central incisor) from the side view of maxillary six anterior teeth. The purpose is to achieve the effective simultaneous intrusion of maxillary (upper) six anterior teeth. For this purpose, co-ordinates of incisal edge of first anterior tooth (maxillary central incisor), point of attachment of elastomeric chain on the archwire and C res of maxillary anterior teeth were considered. From these points, the equation to compute co-ordinates of attachment of mini-implants was formulated. Additionally, the required angle of intrusive force was estimated to be 45°. To verify this computation, finite element analysis was performed on the computer aided design (CAD) structures of maxillary six anterior teeth, surrounding tissues and appliance structures. From the formulated equation, four possible positions of mini-implant placements were considered with reference to incisal edge of first anterior tooth (maxillary central incisor). The co-ordinates of these positions were (11, 10.5) - Position {1}, (12, 11.5) - Position {2}, (13, 12.5) - Position {3}, (14, 13.5) - Position {4} with units in mm. From the photographic results of these positions, different statements of recommendations were given in this study from feasibility point of view. Positions {2} and {3} were highly recommended. Position {4} was moderately recommended. Position {1} was least recommended.

A case report of occlusal reconstruction using an implant prosthesis in a patient with deep overbite and mandibular bilateral molar loss

A case report of occlusal reconstruction using an implant prosthesis in a patient with deep overbite and mandibular bilateral molar loss

ORTHODONTIC CAMOUFLAGE OF CLASS II DIVISION I WITH EXTRACTION OF UPPER PREMOLARS

Class II Division I is the commonest malocclusion found in orthodontic population and a deep overbite is frequently encountered along with it. Many protocols have been utilised in treating such type of malocclusion from removable to fixed appliances with or without extractions. This case report is about a 15-year-old female patient who came to the Department of Orthodontics with a prognathic maxilla and a retrognathic mandible with 11 mm overjet. The patient refused fixed functional treatment thus a upper premolar extraction camouflage treatment was done. The chief complaint of the patient was successfully addressed and overall good treatment results were obtained with improved facial profile and reduced overjet. Keywords: Class II Division I malocclusion, Deep bite, Camouflage

Effect of Using Anterior Bite Plane in the Treatment of Growing Orthodontic Patients with Deep Overbite Malocclusion: A Systematic Review

Effect of Using Anterior Bite Plane in the Treatment of Growing Orthodontic Patients with Deep Overbite Malocclusion: A Systematic Review

Noninvasive Orthodontic Treatment for Class II Division 2 Adult Patient with 100% Deep Bite by Continuous Wire Mechanism

A characteristic of Class II Division 2 malocclusion is severe deep overbite and lingual inclination of the incisors. Deep overbite can be corrected by intrusion of anterior teeth, extrusion of posterior teeth, or a combination of both. Intrusion of the incisors should be the preferred treatment in nongrowing patients with anterior deep bites.

The Effect of Deep Traumatic Overbite on the Periodontium of the Upper Anterior Teeth in a Cohort of Adult Saudi Dental Patients

Aim: to assess the relationship between deep overbite with palatal impingement and periodontal health status in a cohort of adult Saudi dental patients. Materials and Methods:Ten patients (4 males and 6 females, aged 16 to 31 years old) with deep traumatic overbite and palatal impingement were examined. A Hawley retainer appliance with an anterior bite plate was provided for all patients.Pocket depth, bleeding index, gingival index, plaque index and mobility were recorded for four visits after using the appliance with fixed intervals in-between. Repeated measures analysis of variance (ANOVA) was used to assess the differences between visits, control /experimental teeth and surfaces (palatal /labial) for pocket depth, bleeding index, plaque index,gingival index and mobility.

Comparison of clinical outcomes between Invisalign and conventional fixed appliance therapies in adult patients with severe deep overbite treated with nonextraction

The use of aligner therapy for orthodontic treatment has increased substantially in the past decade. However, no study has compared treatment outcomes between the conventional fixed appliance and Invisalign therapies in patients with a severe deep overbite. This study included 50 consecutive adult patients who underwent treatment with either Invisalign (n=25; mean age, 23.3±8.5years) or a conventional fixed appliance (n=25; mean age, 23.1±6.5years) to correct overbite>5mm and>60% deep overbite. Cephalometric analysis and peer assessment rating was used to compare the clinical outcome between groups. Cephalometric analysis showed significant differences in N-Me (P=0.0005) and Mp-L6 (P=0.0001) between Invisalign and fixed appliance treatment groups. No significant differences were observed in the peer assessment rating analysis or total treatment duration between the 2 groups. Both Invisalign and conventional fixed appliances were effective in treating patients with a severe deep overbite. Invisalign therapy may be preferable over conventional fixed appliance therapy in patients with high angle and deep overbite. However, because this study had a retrospective design, the results should be viewed with caution.

Prevalence of Malocclusion and Associated Variables in Preschool Children of Tbilisi, Georgia

Background:Primary dentition is a determinant for future permanent occlusion.Objective:This aimed to evaluate the prevalence of malocclusion and associated variables in the primary dentition among preschoolers in the city of Tbilisi, Georgia.Methods:A cross-sectional survey was conducted among kindergarten children aged 3–5 years. Orthodontic characteristics were assessed by one calibrated clinician (E.G). Questionnaires were given to parents to record associated variables like general health problems, functional changes, and the presence of non-nutritive sucking habits.Results:A total of 396 participants aged 3-5 were included in the study. The prevalence of malocclusion was 49.8%, without significant differences among genders. The prevalence of Class II malocclusion was 21.2%(±4.091), followed by a deep overbite,i.e, 10.7% (±3.14), crossbite,i.e, 7% (±2.561), anterior open bite,i.e, 6.9%, and Class III malocclusion,i.e, 1.6% (±1.513). A total of 41.5% of children with breathing problems had Class II and 13% had crossbite. Speech disorder in 46.8% of cases was associated with anterior open bite. Pacifier users had Class II in 22.5%, deep overbite in 12.2%, and open bite in 9.2% of cases. There was a high prevalence of anterior open bite (25.2%) in children with a thumb-sucking habit (RR=4.90). These data sets are statistically reliable (p &lt; 0.05).Conclusion:Almost half of the evaluated preschoolers had malocclusion. The most frequent disorder was Class II. Malocclusion is associated with non-nutritive sucking habits and mouth breathing.

Predictability of overbite control with the Invisalign appliance

Control of overbite is considered essential in achieving ideal orthodontic outcomes. Questions have been raised regarding the accuracy of ClinCheck software (AlignTechnology, Santa Clara, Calif) in predicting posttreatment outcomes with Invisalign, with the paucity of well-researched literature available on this topic. This research aimed to investigate and determine the accuracy of Invisalign (Align Technology) in correcting a deep overbite by comparing the outcomes predicted by ClinCheck with achieved posttreatment outcomes. A retrospective study was conducted using pretreatment and posttreatment intraoral scans and predicted outcome (ClinCheck) stereolithography files of 42 adult patients consecutively treated with Invisalign from January 2014 and completed before July 2018, selected from the files of 1 experienced orthodontist. Patients included in the study were treated without extractions and with a minimum of 14 dual arch Invisalign aligners using a 2-weekly aligner change protocol. The pretreatment, posttreatment, and predicted outcome stereolithography files for each patient were imported into Geomagic Control X (3D Systems, Rock Hill, SC) software to measure overbite. The deeper the patient's initial overbite and the greater the amount of programmed reduction in overbite according to ClinCheck, the greater the discrepancy in overbite expression posttreatment. ClinCheck over-predicted overbite reduction in 95.3% of patients in which, on average, only 39.2% of the prescribed overbite reduction was expressed. Overbite reduction may result in suboptimal outcomes when using the Invisalign appliance unless remedial measures are employed. The deeper the initial overbite, the more challenging it is to achieve the prescribed posttreatment overbite.

Incisor- Molar Hypomineralization Phenotype Characteristics and Comparison with Amelogenesis Imperfecta: An Approach to a Differential Diagnosis

Background: Incisor-molar hypomineralization (IMH) presents various clinical characteristics that generate confusion for differential diagnosis with other enamel abnormalities such as amelogenesis imperfecta (AI). Purpose: To analyze dental, facial, and skeletal characteristics in people with IMH and compare them to those with AI in order to identify diagnostic differences between these two enamel defects. Methods: Analytical observational study. Twelve 7-to-10-year-olds with IMH and 10 8-to-49-year-olds with AI were studied. IMH was assessed according to the European Academy of Pediatric Dentistry’s diagnostic criteria, Mathu Maju’s criteria (2006), and Neeti Mittal’s phenotypic classification (2016), while Witkop’s criteria (1989) were used to analyze AI. Clinical, radiographic, facial, and skeletal analyses were performed to establish IMH phenotypes, information that was fed into an Excel® database for subsequent statistical analysis (SPSS 22.0) (p&lt;0.05). Results: Statistically significant differences were found between IMH and AI. Only patients with IA presented dilaceration, dental agenesis, and taurodontism. There are similarities regarding facial features such as facial asymmetry, increased intercanthal distance, decreased lower third, biprochelia and convex profile, and occlusal features such as molar relationship, canine relationship, and overjet. Concerning transverse relationships, micrognathism was more frequent in IMH and in vertical relationships, deep overbite was greater in IMH than in AI. Conclusions: The main differences between IMH and AI were evident in skeletal characteristics and associated dental alterations.

A comparative study between the effect of reverse curve of Spee archwires and anterior bite turbos in the treatment of deep overbite cases.

To compare deep overbite treatment using 0.016 × 0.022 nickel-titanium lower reverse curve of Spee archwire (LRCA) or metal anterior bite turbos (ABTs). 48 patients with deep overbite malocclusion were randomly allocated into two groups. Group I (age = 18.4 ± 2.8 years, overbite = 5.8 ± 0.6 mm) was treated with LRCA, while Group II (age = 18.2 ± 3.1 years, overbite = 5.2 ± 0.4 mm) was treated with ABTs bonded to the palatal surface of the upper central incisors. Two cephalograms were taken for each patient, at post-alignment stage (T1) and post-leveling stage (T2). The primary outcomes were the anteroposterior and vertical changes of the lower teeth. The secondary outcomes were the effect on upper incisor inclination and the vertical linear changes of upper teeth, to assess the sagittal and vertical skeletal changes, and to compare the duration of overbite correction. 42 of the 48 patients recruited completed the study (21 in each group). At T2, the lower incisors proclined more in Group I (P ≤ .001). Both lower second molars (P ≤ .001) and lower first molars (P = .001) tipped more distally, while the lower first premolar tipped more mesially, in Group I (P < .05). All cusps of both lower molars showed more extrusion in Group II (P < .05) except for the mesial cusp of lower second molars (P = .095). The duration of overbite correction was shorter using the ABTs by 1.7 months (4.85 ± 1.56 and 3.15 ± 0.93 months for Group I and Group II, respectively). LRCA causes lower incisor proclination with distal tipping of lower molars, while ABTs result in lower posterior tooth extrusion.