Severe Overbite Research Articles

Successful balance of occlusal plane using functional orthopedics appliance

In this article, the treatment of two clinical cases is presented, in which the two patients showed distocclusion, severe overbite, required correction of the occlusal plane and movements of the mandible. Both were treated with functional orthopedic appliances In the first case. the patient was 4 years and 5 months old, and in second, 10 years 10 months old. Both had a significant pathological occlusal plane with a large difference in the height between the right and left sides. The lateral movements of the mandible showed completely different Functional Masticatory Angle Planes. The protrusion and opening movements of the mandible also showed deviation. The Functional Orthopedic appliance would advance the position of the mandible forward and would produce better responses if it were able to touch the incisors in the specific area. The forward mandibular position would activate the Ihh (Indian Hedgehog) and produce replication of the mesenchymal cells in the condyle and glenoid fossa. Moreover, it could produce an increase of mandibular length, and regulate the factors of mandibular condylar growth. The space produced between the occlusion as a result of the change to the forward mandible position must stimulate tooth eruption to correct the curve of the occlusal plane. Both cases showed balance of the occlusal plane and same functional masticatory angle Planes. Furthermore, the protrusion and opening movement of the mandible were corrected and no longer showed deviations. Note in both cases that the stability of the mandibular advancement occurred due to maintenance of twice as long to achieve incisor contact.

PATTERN OF DENTAL OCCLUSION IN A POPULATION OF URHOBO SUBJECTS IN ABRAKA, NIGERIA

The closing order of superior and inferior teeth whilst chewing or at relaxation is termed dental occlusion. Literature exploration divulged want of information on dental occlusion among the Urhobos in Delta State, Nigeria. The endeavour of this work was to consider varied dental occlusion patterns and explore gender variation in dental occlusion patterns amongst the Urhobo tribal cluster in Abraka, Nigeria. Totality of 384 citizens (200 females and 184 males) who were within 15-30 years age set were engaged in this inquisition. The gender gap is a depiction of the male/female scattering in the appraised populace. Records on dental occlusion patterns were composed by having the subjects’ bite, gulp saliva, occlude and open their mouths. The connexion of the upper and lower teeth was labelled as mild overbite, edge to edge bite, negative bite or severe overbite as specified by Eveleth in 1972. Inferential statistics were explored using chi-square by means of Statistical Package for the Social Sciences (SPSS), version 23 and significance level were determined by p < .05. The dental occlusion patterns observed were mild overbite 168 (43.4%), edge-edge bite 146 (38.2%), severe overbite 70 (18.4%) with no negative overbite 0 (0%). The gender dissimilarity in dental occlusion pattern was not notable (p>.05). Mild overbite is preponderant and severe overbite is infrequent amid the Urhobos in Abraka, Nigeria.

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.

Tooth occlusion pattern of the hausas in Zaria, Nigeria

The study was carried out to deduce the tooth occlusion pattern among the Hausas in Zaria, Nigeria. A total of 384 subjects made up of 184 males and 200 females within the ages of 20-49 years participated in this study. Data was collected by means of questionnaire. Results revealed that mild overbite type is the commonest (male = 33.6%, female = 32.6%) which was followed by edge to edge bite (male = 13.3%, female = 10.4%). The incidence of the severe overbite was observed more in males (3.4%) than females (2.1%). The incidence of negative overbite was observed more in females (2.9%) than males (1.8%). The results showed no significant gender difference (p≥0.05) in the tooth occlusion pattern. The tooth occlusion pattern of the Hausas in Zaria, Nigeria is such that some occlusion types are relatively more common in females than the male counterparts and vice versa. The mild overbite type of occlusion is the commonest among the Hausas in Zaria, Nigeria. The negative overbite is the least common tooth occlusion pattern among the Hausas in Zaria, Nigeria.
 Key words: Nigeria; Occlusion; Pattern; Tooth; Zaria

Two middle-aged cases of deep overbite without molar support treated by orthognathic surgery

IntroductionPatients with severe overbite in middle age often undergo prosthetic treatment without a diagnosis of dentofacial deformity, but soft tissue trauma can occur in such patients due to the lack of inter-occlusal space. Comprehensive surgical orthodontic treatment and prosthetic treatment are indicated to correct the overbite and soft tissue injury for such patients. Presentation of caseWe report the cases of two middle-aged patients with dentofacial deformity and severe overbite without molar support. In both cases, prosthetic treatment had been performed for many years without any improvement of the occlusion. Case 1: A 47-year-old Japanese man had a maxillary incisor protrusion and reduced lower anterior facial height profile with the left mandibular molars lost due to periodontal disease. After preoperative orthodontic treatment and occlusal elevation in the molar teeth using an implant prosthesis, a sagittal split ramus osteotomy (SSRO) was performed. Case 2: A 57-year-old Japanese woman had mandibular retrognathia with maxilla and mandibular-arch length discrepancy. The left mandibular molars needed to be extracted due to periodontal disease. After preoperative orthodontic treatment and reconstruction of the molar occlusion using an implant prosthesis, three-segment Le Fort I osteotomy and SSRO were performed. DiscussionMalocclusion with dentofacial deformity is a risk factor for severe deep overbite or other occlusion collapse. ConclusionIn middle-aged patients with deep overbite with missing molar teeth, we should consider both prosthodontic treatment and comprehensive dental therapy, including orthognathic surgery.

Long term outcome after surgical correction of mandibular brachygnathia with unilateral type 1 external skeletal fixation

To describe complications and long-term outcome after surgical correction of severe overbite in 7 horses using corrective osteotomy and a Type I external fixator. Case series. Horses (n = 7). Seven horses with severe mandibular brachygnathia were treated by corrective osteotomy and a Type I external fixator. Data on surgical technique, complications, long-term outcome and owner satisfaction were recorded. Severe mandibular brachygnathia was corrected successfully in all horses. Short term follow-up revealed a relatively high morbidity due to several complications such as surgical site infection, sequestrum formation and instability due to early pin loosening. Long-term over all owner satisfaction was very high. Corrective osteotomy and fixation with an external fixator is an effective surgical technique for correction of severe mandibular brachygnathia and offers good results in a long-term perspective.

European College of Orthodontics

Date of birth 7/12/1995; gender: female. 1/6/2007; 11 year and 6 months. Class II, division 1 malocclusion associated with severe overbite; skeletal hypodivergency; complete set of teeth. Customized Incognito® bi-maxillary multi-bracket appliance with a series of ribbonwise archwires (dimension: .025 × .018′′); levelling; correction of the anteroposterior dimension using a Herbst appliance; finishings with .0182 × .0182 βtitanium; retention. 2/1/2010; 14 years and 11 months. Wires bonded from 13 to 23 and from 33 to 43 combined with an Andreasen activator at night; monitoring of possible evolution of third molars. 18/5/2011; 15 years and 4 months. Extra-oral examination: frontal view: slight predominance of the mid third, thin upper lip; lateral view: convexity, open nasolabial angle, retrusive chin and pronounced naso-labial fold. Patient consulted for the position of her anterior teeth which she thought to be “sticking out”. Endo-oral examination: no crowding on either arch; Angle Class II relationships; pronounced anteroposterior overjet; pronounced overbite. Dental panorex: complete set of teeth; second molars unerupted.

Tratamento de mordida profunda segundo a técnica do arco segmentado

Neste estudo, apresenta-se relato de caso clínico de um paciente do gênero masculino, com 11 anos e 2 meses, portador de maloclusão de classe II de Angle, sobremordida e curva de Spee acentuadas e tendência de crescimento equilibrado. Após análise do perfil do paciente, dos modelos de estudo e da avaliação cefalométrica, optou-se pelo tratamento com disjunção, exodontia de quatro pré-molares, intrusão dos dentes anteriores inferiores, segundo a técnica do arco segmentado. Essa técnica consiste em uma seqüência de procedimentos ortodônticos baseados em princípios mecânicos, guiados por sistemas de forças, que regem a movimentação dos dentes, o que possibilita controlá-la da melhor maneira, levando em consideração a magnitude e o ponto de aplicação da força, a localização do centro de resistência e a rotação para aplicação da técnica. Neste trabalho, tem-se como objetivo analisar essa opção de tratamento da mordida profunda e também sua filosofia e princípios mecânicos.

A new look at the treatment of Class II Division 2 malocclusions

This case report illustrates a treatment option for managing a skeletal Class II relationship with a Class II Division 2 malocclusion and impinging overbite. The patient's maxillary first premolars were extracted during unsuccessful orthodontic treatment at age 15. These extractions and the retraction of the maxillary anterior teeth during space closure worsened the facial profile deficiency caused by the original facial skeletal Class II discrepancies. During the retreatment described here, the second premolars were moved into the place of the previously extracted first premolars. The opened spaces at the second premolars were then restored with implant-supported restorations. Lingual brackets were used to correct the severe overbite. This approach created sufficient overjet to correct the Class II skeletal relationship with bisagittal mandibular advancement osteotomy. Reconstruction of the skeletal and occlusal relationships resulted in a more desirable facial profile for this patient.

Mikrognati dan Mikroglosi Kongenital

A case of congenital micrognathia and microglossia was observed between the ages of 6.5 and 8 years in a boy patient. The lower arch was extremely narrow and the tongue was extremely thin, small, and smooth. Speech disorder, absence of 13, 23, 32, 42, and severe overbite occlusion accompanied that case. The etiology in connection with the growth and development, the insertion of upper and lower prosthesis were discussed in this paper.

Prevalence and distribution of selected occlusal characteristics in the US population, 1988-1991.

The inclusion of occusal traits as part of the oral health component of the Third National Health and Nutrition Examination Survey, Phase 1, 1988-91, provided an opportunity to assess several occlusal characteristics in the US population: diastema > or = 2 mm, alignment of lower and upper anterior teeth, posterior crossbite, overbite, and overjet. Household questionnaires asked whether the individual had ever received orthodontic treatment. Prevalence of clinical measures of occlusal characteristics and orthodontic treatment was estimated for over 7,000 sample persons from 8 to 50 years of age, representing approximately 150 million non-institutionalized people in the United States. These findings present the first estimates of occlusal status of the US non-institutionalized population in more than 25 years. Eight percent of the population had severe overbite of 6 mm or more. The average overbite was 2.9 mm. Maxillary diastemas > or = 2 mm were observed in 19% of 8-11-year-olds, 6% of 12-17-year-olds, and 5% of adults 18-50 years old. Twenty-five percent and 22% of persons had zero mm of malalignment in maxillary and mandibular incisors, respectively. Conversely, 11% and 15% of persons had 6 mm or more displacement of maxillary and mandibular molars, respectively. Posterior crossbite affects less than 10% of this population, and less than 10% had overjet of 6 mm or more. Non-Hispanic black adults had the least amount of malalignment in mandibular incisors. Three times as many non-Hispanic blacks compared with non-Hispanic whites and Mexican-Americans had diastemas > or = 2 mm. Comparisons with published data from the National Health Examination Survey (1966-70) indicated a 20% increase of 12-17-year-olds with overbite in the normal range (0-3 mm). Almost 20% of adults ages 18-50, as well as 18% of children, have had orthodontic treatment.

Hypoglossia: Case report and discussion

A case of hypoglossia was observed between the ages of 3 and 15 years in a patient with micrognathia, congenital absence of three lower incisors, and a telescopic occlusion accompanied by an extremely narrow lower arch and severe overbite. Orthodontic intervention was begun when the patient was 8 years old. Craniofacial growth changes that occurred before and after orthodontic treatment are discussed. Cephalometric study of this case suggests the distinctive features of the postnatal growth pattern similar to other cases with this syndrome.

Cooley's anemia—Orthodontic and surgical treatment

T here are some disease entities which have important orthodontic implications but which are rarely seen in the orthodontic practice. Consequently, little attention is paid to them. Nevertheless, it is important to record whatever experience is accumulated regarding orthodontic diagnosis and treatment for such conditions. Cooley’s anemia (thalassemia, erythroblastic anemia, or Mediterranean anemia) is a blood dyscrasia characterized by a peculiar alteration in skull and long bone structure which produces a Mongoloid facial appearance (Figs. 1 and 2). Other clinical manifestations are icterus (jaundice) and enlargement of the spleen and heart. The disease is congenital and affects almost exclusively persons of Mediterranean extraction, chiefly Greek or Italian. In severe cases the maxilla is grossly enlarged and the malar bones bulge markedly. These bony changes are related to the enlargement of marrow spaces in response to a stimulus for increased production of red cells. Radiographically, these patients exhibit enlarged marrow spaces in the jaws and thinning of the cortical layers (Fig. 3). There is a severe retardation of maturation, which is observable in carpal radiographs, and a widening of the diploic spaces in the skull. As a result of the active marrow hyperplasia, pneumatization of the maxillary sinuses fails to occur at the proper time and there is considerable overgrowth of the maxilla. This causes severe overbite, prominence of the upper incisor teeth, and separation of the orbits.’ The trabeculae of the thickened diploic spaces often become arranged vertically, giving the “hair-on-end” appearance described in the literature. Preventive procedures are now being developed and appear promising. According to one investigator,* the facial disfigurement seen in these patients can be prevented by periodic transfusion therapy, as long as the hemoglobin is kept at an optimal level and therapy is started by the fifteenth month of life. Kaplan and associates3 described dental and oral findings in a study of fifty cases; 64 percent of the patients showed the maxillary deformities previously described, but the DMF rate and gingival inflammation were not unusual. Johnston and Krogman4 studied the patterns of growth of fifty persons with Cooley’s anemia. They concluded that the growth patterns of these children were characterized by a retardation in normal growth

Treatment of severe overbite malocclusion

Treatment of severe overbite malocclusion