Overbite Research Articles

Comparison of Intrusive Effects and Amount of Root Resorption in Maxillary Incisors Using Two Conventional Intrusion Arches and Mini-Implants

ABSTRACT Aim and Objective: This study aimed to compare the amount of maxillary incisor intrusion and root resorption using three methods: mini-implants, utility arches, and Connecticut intrusion arches. Materials and Methods: Eighteen patients aged 15 to 25 years with deep bite were divided into three groups: 10 patients each for mini-implant, utility arch, and Connecticut intrusion arch groups. Bilateral mini-implants were used in Group 1, while utility and Connecticut arches were used in Groups 2 and 3, respectively. Intrusion was performed over four months. Lateral cephalograms and orthopantomograms were taken at the start (T1) and after four months (T2). Results: The mean incisor intrusion measured by U1-PP was 2.08 mm in Group 1, 1.55 mm in Group 2, and 1.75 mm in Group 3 (P < 0.05). CR-PP measurements showed 1.91 mm in Group 1, 1.56 mm in Group 2, and 1.66 mm in Group 3 (P < 0.05). Incisors in Group 1 showed minimal protrusion compared to significant protrusion in Groups 2 and 3 (P < 0.05). Maxillary molars showed no significant changes in Group 1 but distal tipping in Groups 2 and 3 (P < 0.05). No root resorption was observed in any group. Conclusion: Mini-screws demonstrated the most effective maxillary incisor intrusion with minimal side effects compared to utility and Connecticut intrusion arches.

Intrusion Of Maxillary Anterior Teeth: A Comparative Clinical Study Between Mini-Implants And Utility Arch

Background: Deep bite is a common orthodontic malocclusion caused by factors like incisor supra-occlusion, molar infra-occlusion, or incisor angulation. Nonsurgical correction of deep bite involves extrusion of posterior teeth, intrusion of incisors, or both. Extrusion of posterior teeth in growing patients provides stable results due to secondary remodelling. In patients with deep bite and excessive gingival display, intrusion of incisors is typically required which can be accomplished using intrusion arches or mini-implants. Materials and Methods: A total of 10 subjects with an anterior deep bite (overbite >4mm) with excessive incisal display at rest and at smile were taken. Participants were evenly allocated into two groups based on their gingival display. Group I included five participants with less than 4 mm of gingival display, who received treatment using Rickett’s intrusion utility arch. Group II consisted of five subjects with more than 4 mm of gingival display, who were treated with two anterior mini-implants. Lateral cephalograms were utilized to evaluate maxillary anterior intrusion at two specific time points: Pre-treatment (T1) and following a 6-month interval (T2). Results: The amount of bite opening in both groups was comparable, however the amount of incisor intrusion was greater with mini-implants than with the utility arch. The utility arch group showed significantly greater labial tipping (P<0.01) and increased overjet (P<0.05) compared to the mini-implant group. The distance between the maxillary first molar (U6) and palatal plane (PP) significantly increased with the utility arch but decreased with mini-implants. The mandibular plane angle (GoGn-Sn) increased with the utility arch and decreased with mini-implants; however, the difference was statistically non-significant. Conclusion: Deep bite correction with intrusion utility arch occurs through incisor intrusion, incisor flaring, and molar extrusion, whereas with mini-implants, bite opening mainly occurs through incisor intrusion, making it an efficient alternative in cases where dental side effects such as incisor flaring and molar extrusion are undesirable.

A 3D finite element analysis of biomechanical effects on teeth and bone during true intrusion of anteriors using miniscrews

The primary objective of this study was to investigate the biomechanical effects and stresses on bone, periodontal ligament (PDL), cementum and displacement along X-, Y- and Z-axis during true intrusion of incisors using mini-implants with Finite Element Analysis; the secondary objective of the study was to find out the best method for anterior intrusion in clinical practice to treat anterior deep bite malocclusions. A 3D finite element method was used to simulate true anterior intrusion with sliding mechanics using mini-implants. Two groups were modelled with mini-implants placed distal to lateral incisors for Model1, and below the anteriornasalspine (ANS) for Model2, to achieve intrusion. von Mises stress, principal stress on PDL and alveolar bone, displacements in all 3 planes were determined. Amongst the modalities compared in the present study, the stresses on bone and PDL were showing best behavior for mini-implants placed distal to lateral incisors (Model1). The teeth showed controlled tooth movement in Model1. Maximum stress was found in the cortical bone and in the PDL. Nature of the stress changed from compressive to tensile from cervical area to root apex, concentrating mainly at the apical area. Amongst the modalities compared, the best controlled tooth movements for anterior intrusion to treat anterior deep bite malocclusions, was for mini-implants placed distal to lateral incisors (Model1).

Fixed Prosthodontic Rehabilitation of a Patient with Cleidocranial Dysplasia: A Case Report

Introduction Cleidocranial Dysplasia (CCD) is a rare congenital disease characterized by skeletal and dental anomalies. Clinical findings of CCD patients include low facial height, pseudoprognathism, unerupted teeth, an excessive deep bite, chewing difficulties, and unsatisfied dentofacial appearance. These patients’ dental treatments present a substantial challenge. Case Representation This case report describes the prosthodontic treatment of a 29-year-old male CCD patient using porcelain-fused-to-metal restorations. The avoidance of a surgical procedure serves to minimize the potential for complications and expedites the attainment of outcomes with greater celerity. Throughout the follow-up period of 1 year, the patient maintained good periodontal health. The restoration of masticatory function and enhancement of facial esthetics were successfully achieved and the patient expressed a high degree of satisfaction with the outcome of the treatment. Conclusion The use of fixed prostheses in CCD patients is a treatment modality that resolves many of the issues caused by the surgical approach.

Enhancing smile in class II division 2 malocclusion using utility arch – A Case report

Class II Division 2 malocclusion is a dental condition characterized by retroclined maxillary central incisors, often accompanied by a deep bite and a Class II skeletal relationship. The utility arch, an orthodontic appliance designed to exert controlled forces on the dentition, offers a promising approach for correcting this type of malocclusion. By making strategic adjustments, such as a V bend in the vestibular bridge, the utility arch can be effectively used to procline incisors. This case report details the application of a utility arch in treating a growing patient with Class II Division 2 malocclusion. The treatment plan aimed to leverage the patient's growth period to enhance the stability of the correction, ensuring a favorable long-term outcome.

Prevalence of Malocclusion among School aged Children and Adolescents in Kabul, Afghanistan

One of the major public health concerns is the prevalence of malocclusion among school-aged children. Malaligned teeth and incorrect jaw posture are referred to as malocclusion, and they can cause a number of functional and cosmetic problems. The aim of this study was to investigate the prevalence of malocclusion in school-aged children and adolescents in Kabul, Afghanistan. This descriptive cross-sectional study was conducted at the Faculty of Dentistry, Kabul University of Medical Sciences “Abu Ali Ibn Sina” (KUMS). The data were collected from High schools in Kabul, Afghanistan during 2019 and 2020. A sample of 479 children and adolescents, 236 females (49.3%) and 243 males (50.7%) 8-18 years old (mean age 14.16±2.8) were randomly selected from four high schools of different districts of Kabul city. We used the angle classification for sagittal plane malocclusion; open bite and deep bite for vertical plane malocclusions; cross bites for transverse plane malocclusion; midline diastema, spacing and crowding show the tooth material and arch length discrepancies. This study demonstrated that only 41 (8.6%) of subjects had normal occlusion while 92.4% of subjects had different types of malocclusions. Class I malocclusion was found in 275 subjects ( (57.4%, class II Division 1 in 63 subjects (13.1%), Class II Division 2 in 64 subjects (13.4%), Class III malocclusion in 36 subjects (7.5%), moreover, crowding in 183 (38.2%), spacing in 79 (16.5%), midline diastema in 54 (11.3%), crossbite in 77 subjects (16.1%), open bite in 23 subjects (4.8%) and deep overbite in 44 subjects (9.2%) were found. According to Angle’s classification of malocclusion class I malocclusion was the most prevalent malocclusion and class III was the least prevalent malocclusion in school-aged children and adolescents in Kabul city.

Current Trends in Pediatric Orthodontics: A Comprehensive Review.

Pediatric orthodontics is a critical field focusing on the diagnosis, prevention, and treatment of dental and facial irregularities in children. This comprehensive review explores current trends and methodologies in pediatric orthodontics and discusses the multifactorial etiology of malocclusions, including genetic, environmental, and disease-related factors. The importance of proper diagnosis is highlighted, and the extraoral, intraoral, and functional evaluations essential for effective treatment planning are detailed. Various orthodontic conditions such as Class III and Class II malocclusions, abnormal oral habits, arch length discrepancies, anterior and posterior crossbites, open bites, and deep bites are examined in depth. The review also addresses the role of temporomandibular joint disorders (TMDs) and obstructive sleep apnea (OSA) in pediatric patients, emphasizing the need for early and accurate diagnosis to facilitate appropriate intervention. The use of clear aligners in early orthodontic intervention is evaluated given their efficacy and improved patient satisfaction compared to traditional appliances. Additionally, the article discusses the non-advisability of early interception for certain self-correcting malocclusions and the limitations of pediatric orthodontic treatment, including compliance-related issues and the unique anatomical considerations of deciduous dentition. This review aims to provide a detailed understanding of contemporary practices and challenges in pediatric orthodontics, offering insights for clinicians to enhance treatment outcomes and patient care.

EVALUATION OF THE RELATIONSHIP OF CURVE OF SPEE WITH DENTOSKELETAL MORPHOLOGY IN SAGITTAL MALOCCLUSIONS

Curve of Spee is defined as the line on a cylinder which is tangent to incisal edges of lower anteriors, occlusal surface of lower second molar and anterior border of condyle. The aim of the study is to determine whether there is a relationship between curve of Spee and craniofacial morphology in different sagittal malocclusions and to determine the influence of craniofacial morphological features in different sagittal malocclusions on curve of Spee. The research consists in the analysis of lateral cephalograms and study models of 90 patients, age 15-25 years which includes skeletal class I, class II and skeletal class III. Patients are divided into three groups: group A-flat curve of Spee i.e. < 2mm, group B - normal curve of Spee i.e. 2-3 mm, and group C - deep curve of Spee i.e. >3mm. In the literature, there is little data on research that has been done on this topic, on the other hand, in our daily work as orthodontists, we encounter the problem of leveling the deep bite.

Jaw Morphology and Factors Associated with Upper Impacted Canines: Case-Controlled Trial

Introduction and aim: Orthodontic treatment of impacted maxillary canines is challenging and expensive. This study investigated factors associated with impaction risk and the need for surgical exposure. Methods: Seventy-five participants of similar age, skeletal maturity, and gender (32 impacted canines, 43 controls) were included in the case-controlled trial. Three-dimensional study models were created (Trios 3, 3Shape), and panoramic radiographs were taken. The 3D digital models were measured using software to obtain morphological characteristics of the maxilla, such as maxillary surface area (mm2) and volume (mm3). Results: The impacted canine group displayed a significantly higher prevalence of deep bite (OR = 5.01), hypoplastic lateral incisors (OR = 5.47), and rotated adjacent teeth (OR = 3.56) compared to the control group. The impacted canine group exhibited a smaller maxillary surface area and volume. Within the impacted canine group, factors associated with a greater need for surgical exposure included the presence of a persistent deciduous canine (OR = 10.15), a palatal canine position (OR = 7.50), and a steeper canine angulation (p < 0.001). Conclusions: These findings suggest that several signs can serve as potential predictors of increased risk for maxillary canine impaction and the need for surgical intervention. Identifying these factors can aid in early diagnosis and treatment planning for improved patient outcomes.

The effect of early childhood non-nutritive sucking behavior including pacifiers on malocclusion: a randomized controlled trial.

Systematic reviews on the effects of pacifiers on occlusion have highlighted the need for quality RCTs. Single region, three parallel-armed, prospective, randomized controlled trial. To investigate the correlations between early childhood non-nutritive sucking habits and malocclusion. Specifically to test whether the use of a study pacifier has differing effects compared to other pacifiers and control, and whether the duration of pacifier use or digit sucking influence the occlusion. The subjects were firstborn children, born in 2008 in Vantaa, Finland. One-third of participants were offered study pacifiers, free of charge, from birth up to 2 years of age. The history of the subjects' sucking habits, including pacifier use was screened in a questionnaire at the age of 2 years, and clinical examinations were performed at the age of 7 years. In addition, the subjects were divided into groups that were equally matched regarding their mother's level of education. Posterior crossbite, anterior crossbite, overjet, deep bite, open bite, and crowding. Three districts were randomly allocated to three study groups by drawing lots. It was not possible to blind the clinicians or parents from the intervention. Blinding during data analysis was performed. From the original cohort of 2715 children born in the town of Vantaa, 1911 were excluded and 353 were lost to follow-up. The remaining 451 children were divided into three groups according to the use of pacifiers. The prevalence of posterior crossbite at the age of 7 years was higher if a non-study pacifier had been used (P = .005) even when matched for the mother's level of education (P = .029). The prevalence of posterior crossbite was higher if the pacifier habit had continued for 12 months or more compared to 11 months or less, 7% and 1%, respectively, (P = .003). Digit sucking for 12 months or more was associated with crowding (P = .016). The prevalence of crossbite in the study pacifier group was less than in control pacifiers. No adverse harms were reported other than effects on the dentition. The use of pacifiers is associated with the posterior crossbite, especially if their use continues for a year or more. Parents/guardians should be advised to stop the use or reduce the use of pacifiers to a minimum after their child's first birthday. ClinicalTrials.gov NCT01854502.

Does Invisalign Outperform Fixed Appliance in Treating Vertical Discrepancies?

Aligners became popular among adult patients for their superior aesthetics and comfort in comparison to conventional fixedappliances. It has undergone numerous enhancements over time, allowing it to address more complex malocclusions. Many researchers argued that managing vertical discrepancies is more challenging than addressing anteroposterior issues. This complexity arose from the mechanical requirements for treatment and the required mechanics to prevent relapse. Studies assessing the treatment outcome of anterior open bite closure using clear aligners have yielded conflicting results regarding the mechanisms of bite closure. Proposed mechanisms included extrusion of upper or lower incisors, lingual tipping of upper or lower incisors, intrusion of upper or lower molars, counterclockwise rotation of the mandible, or various combinations of these mechanisms. The research highlighted the biomechanical challenges associated with using aligners for the treatment of deep bites as mandibular incisor intrusion and leveling the curve of Spee remain among the least predictable movements. Given the widespread use of aligners, it is imperative to rigorously assess the effectiveness of clear aligners in achieving overbite correction to ensure they deliver the desired outcome. This review aimed to assess the performance of Invisalign in the management of vertical discrepancies. It sought to identify the dentoskeletal effects of clear aligners in addressing deep bite and anterior open bite cases, understand the mechanisms behind overbite correction, and provide a comprehensive overview of the existing research on this topic.

Treatment of non-compliant skeletal class II malocclusion with a hybrid appliance – A case report and review literature

The present case describes a case of skeletal deep bite class II malocclusion treated efficiently using the Forsus appliance, and its importance of clinical and biomechanical considerations. Skeletal deep bite class II malocclusions with deficient mandibles are treated with different functional appliances. There are several appliances for its correction in a growing child. However, fixed functional appliances are commonly used in the present clinical scenario for those non-compliant cases, who present late with less residual growth or no growth. This case was treated with a pre-adjusted edgewise appliance supplemented with a device known as Forsus Fatigue Resistant Device (FFRD) (3M Unitek Corp, California, USA). FFRD is a good alternative device for skeletal deep bite class II malocclusions instead of class II elastics in mild cases and place of Herbst appliance in severe cases. Biomechanical principles should be considered for those patients with the Forsus appliance to prevent complications. There are fewer complaints from the patients and treatment time is less.

Evaluating malocclusion patterns in children with autism spectrum disorder using the index of complexity, outcome and need: a cross-sectional study

BackgroundThe purpose of this study was to evaluate the complexity of malocclusion and existing patterns in children with autism spectrum disorders (ASD) using the index of complexity, outcome and need (ICON).MethodsThis cross-sectional study included children diagnosed with ASD, aged 9–15 years. A group of healthy children with the same demographic characteristics was randomly selected as the control group. Malocclusion was assessed according to ICON scoring protocol. The following parameters were recorded: dental aesthetics, upper arch crowding/spacing, presence of crossbite, anterior-vertical relationship (open and deep bite) and buccal segment anterior-posterior relationship. Finally, an overall ICON score was derived and reported for each patient. Descriptive analysis was performed for all investigated variables. Significance level was set at p < 0.05.ResultsA total of 324 children, divided into ASD (162) and control (162) groups, comprised the study population. Our results demonstrated that the average overall ICON score was significantly higher in the ASD group compared to the control group (38.77 vs. 27.43, p < 0.001). ASD children also obtained significantly higher scores regarding the dental aesthetics component (3.84 vs 2.78, p < 0.001). Study groups were significantly different in terms of the prevalence of incisor overbite and open bite (p = 0.002 and p < 0.001, respectively). Patients in the ASD group showed a higher prevalence of Class II and Class III malocclusions (p < 0.001).ConclusionASD children obtained significantly higher overall ICON scores, indicating more complex and severe malocclusions. These children also exhibited a greater tendency towards Class II and III malocclusions.

Use of Orthodontic Mini-Implants in Conjunction with Elastics for Extrusion of Impacted Canines and Correction of Bimaxillary Protrusion.

Orthodontic extrusion of canines, although challenging, can yield excellent results without tooth extraction. Temporary anchorage devices (TADs), involving mini-implants in the alveolar bone, offer stable anchorage via biomechanics. This case report details orthodontic extrusion of bilaterally impacted maxillary canines using TAD mini-implants and elastics. The patient had bimaxillary protrusion, moderate crowding, deep bite, and vertical growth pattern, necessitating careful treatment planning. The combination of TAD mini-implants with Class-II elastics simplified biomechanics. The treatment achieved efficient results, maintained adjacent teeth positioning, and improved patient compliance.

Prevalence of Malocclusion and Orthodontic Treatment Need in 9- to 12-Year-Old Schoolchildren in Ulaanbaatar, Mongolia.

Background The prevalence of malocclusion in Mongolia is increasing every year. Estimating the need for orthodontic treatment in the population is crucial for planning orthodontic care services and monitoring oral health programs. Therefore, the present study aimed to assess the need for orthodontic treatment among schoolchildren in Ulaanbaatar, Mongolia, using the Index of Orthodontic Treatment Need (IOTN). Methods A total of 656 schoolchildren aged 9-12 years were enrolled from 8 schools located in urban and suburban areas of 6 districts of Ulaanbaatar city. All the children were assessed according to the two components of the IOTN, the Dental Health Component (DHC) and the aesthetic component (AC). Statistical analyses were carried out using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States). Results The prevalence of malocclusion was 561 (84.5%), consisting of 452 (68%) Angle Class I, 178 (26.8%) Angle Class II, and 34 (5.2%) Angle Class III malocclusion. For the DHC, the moderate need for treatment was 194 (29.3%) and the definite need was 53 (8.1%). For the AC, the moderate need was 148 (22.3%) and the definite need was 45 (6.9%). The association between the DHC and the AC was found to be statistically significant (p<0.001). The most common malocclusions were an increased overjet (maxillary protrusion), a contact point displacement (crowding), and an increased overbite (deep bite). The AC, Angle's molar relationship, an increased overjet, a contact point displacement, and an increased overbite were factors associated with the need for orthodontic treatment. Conclusion Approximately one-third of schoolchildren in Ulaanbaatar, Mongolia, require orthodontic treatment. This finding helps dental practitioners to better understand oral health problems, leading to an improvement in the overall quality of life of children.

Redefining the Envelope of Discrepancy in Contemporary Orthodontics: A Narrative Review

Abstract Redefining the envelope of discrepancy with temporary anchorage devices (TADs) refers to the use of mini-implants, miniplates, or miniscrews in orthodontics to expand the range of possible tooth movements and correct complex dental discrepancies. By strategically placing TADs in specific locations, orthodontists can create an augmented anchorage system that enables them to move teeth in ways that were previously not feasible. This expanded envelope of discrepancy allows for more efficient and effective treatment of complex malocclusions, including retraction of teeth, correction of severe crowding, open bites, deep bites, and cases with missing teeth. TADs allow orthodontists to have greater control over tooth movements, as they provide stable and reliable anchorage points. Orthodontists can tackle more challenging cases that were considered difficult or even impossible to treat. TADs minimize the dependence on patient cooperation since they provide additional anchorage independent of patient compliance. They can accelerate treatment by allowing orthodontists to move teeth more efficiently and effectively. Thus, treatment duration can be shortened, reducing the overall time patients spend in braces or aligners. Overall, redefining the envelope of discrepancy with TADs has significantly expanded the possibilities in orthodontic treatment, allowing for more precise and efficient correction of complex dental discrepancies.

Orthodontic and orthopedic rehabilitation of adult patients with congenital cleft lip and palate (clinical case)

Congenital cleft lip, alveolar process, hard and soft palate are common anomalies of the development of human organs and in terms of frequency occupy one of the first places among other defects of the human body. The clinical study and treatment of cleft lip and palate, malocclusions that accompany this defect have always been of great interest in orthodontics and orthopedic dentistry. This is due to the fact that malocclusions in this group of patients are complex and difficult to treat, as morphological changes are combined with significant functional disorders. The aim of the work was to demonstrate a clinical case of orthodontic and orthopedic rehabilitation of patients with congenital bilateral cleft lip and palate after cheilouranoplasty. A clinical case of a complex treatment of a 25-year-old female patient with bilateral cleft lip, alveolar process, hard and soft palate after cheilouranoplasty performed in childhood is presented. During the clinical examination, an irregular shape of the upper dentition was established due to its sharp narrowing and alveolar shortening in the area of canines and first premolars. A deep reverse bite was formed, a false progeny with a sagittal fissure of up to 10 mm, bilateral vestibular crossbite, contact on the first and second molars of the upper and lower jaws was observed, adentia 12, 22, 23. With a sharp narrowing of the upper dentition at the first stage of orthodontic treatment, Nord's apparatus was used. At the second stage, the brace technique was applied, namely, the straight arch technique. After expanding, lengthening the upper dentition, creating space for missing teeth, reducing the size of the lower dentition by removing 34, 44, the patient continued treatment at the orthopedic department. At an appointment with an orthopedic dentist, after an objective and subjective examination, according to Kennedy the patient was diagnosed as III class, I subclass of the upper jaw. Defects of the alveolar process of the upper jaw, formed as a result of adentia, connection of the oral cavity with the nasal cavity in places of non-union of the alveolar process were established. In this clinical situation, the manufacturing of a complete esthetic-cosmetic structure, namely a metal-ceramic dental bridge with obturating parts is indicated. Thus, the demonstrated clinical case can be considered as one of the methods of a complex orthodontic and orthopedic rehabilitation of adult patients with congenital cleft lip, alveolar process and palate.

Evaluation of the Best Method for Orthodontic Correction of Skeletal Deep Bites in Growing Patients: A Systematic Review.

This review aimed to evaluate the currently available evidence regarding the best method of correcting deep bites in growing patients. In September 2023, a search was conducted electronically across the following databases: PubMed®, Web of Science™, Scopus®, Embase®, Google™ Scholar, and Cochrane Library. In this systematic review, randomized control trials (RCTs), controlled clinical trials (CCTs), and cohort studies of growing patients with deep bite malocclusion who received treatment with the primary objective of treating the deep bite were included. Risk of bias of the included studies was assessed using two different tools; one tool was applied for RCTs and the other one for the CCTs and cohort studies. One RCT, one CCT, and one cohort study were included (85 patients). The flat fixed acrylic bite plane was superior in terms of duration of treatment when compared to the inclined fixed acrylic bite plane and the utility arch with posterior intermaxillary elastics. Limited evidence indicates that the inclined fixed acrylic bite plane causes a significant increase in the lower incisor inclination and a significant increase in the angle between the mandible and the anterior cranial base (SNB). However, limited evidence indicates that the utility arch with posterior intermaxillary elastics causes a significant decrease in the angle between the maxilla and the anterior cranial base (SNA). Regarding the vertical skeletal changes, it was found that the three methods were comparable; in each case, the vertical dimension of the face increased because of a significant increase in the lower first molar height. There is a need for further studies to strengthen the evidence of the treatment efficacy of the employed methods, with more RCTs to be conducted in this regard.

ASSESSMENT OF THE TREATMENT QUALITY OF PATIENTS WITH FUNCTIONAL DISORDERS OF THE DENTO-MAGULAR APPARATUS COMBINED WITH THE DENTOALVEOLAR FORM OF DEEP BITE

Introduction. Patients with a deep bite and dental restorations are at increased risk of unfixing of fixed appliances and other complications due to occlusal defects. The problem of the volume of dental interventions and rational choice of the type, as well as the elimination of complications after their implementation, is relevant and unsolved, especially in patients with disorders of the dental and jaw apparatus, combined with the dentoalveolar form of a deep bite. The aim of the research was to improve the quality of orthodontic treatment of patients with a deep bite, existing reconstructive restorations and occlusal disorders by developing a scientifically based clinical algorithm for fixation of fixed orthodontic equipment. Materials and methods. The main group – 29 patients who were treated according to the scheme of fixation of non-removable equipment developed by us and the use of myorelaxation methods, and the research group – 22 people who were treated with generally accepted method. Methods: questionnaires, clinical and radiological, instrumental and statistical. The results of our experimental study of patients illustrated that the scheme of the proposed algorithm for fixing fixed appliances in the future will have the opportunity to increase the efficiency of providing dental care and will be implemented in the treatment process in patients with a deep bite, because they are in the group of increased risk of unpredicted debonding of fixed orthodontic appliances. Conclusions. The results of our experimental study of patients illustrated that the scheme of the proposed algorithm for fixing fixed appliances in the future will have the opportunity to increase the efficiency of dental care and will be implemented in the treatment process in patients with a deep bite, because they are in the group of increased risk of unpredicted debonding of fixed orthodontic appliances.

Partial amputation due to tongue bite in death-associated with eclampsia.

Eclampsia is one of the most dangerous complications of pregnancy and has a high incidence in developing countries. It is characterized by coma and the occurrence of generalized tonic-clonic seizures in pregnant women with hypertension. Deep bites on the tongue and other orofacial injuries have been described as consequences of these seizures. We present a case of death associated with eclampsia in which the bite during the seizure episode caused almost total amputation of an enlarged tongue (macroglossia). The medico-legal value of this finding and the situation due to antecedent pathological conditions and lack of routine screening in pregnant women who may migrate legally or illegally to give birth with better medical care are discussed.