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MANAGEMENT OF DEEP BITE

INTRODUCTION
Deep bite is defined as a condition of excessive
overbite, where the vertical measurement
between maxillary and mandibular incisal
margins is excessive when mandible is brought
into habitual or centric occlusion.
Overjet implies horizontal overlapping of
incisors.
Overbite refers to vertical overlapping of
incisors.

CLASSIFICATION:

INCOMPLETE

DEEP BITE
COMPLETE

DENTAL

SKELETAL

INCOMPLETE DEEP BITE


An incisor relationship in which the lower
incisor fails to occlude with either the
upper incisors or the mucosa of the palate
when teeth are occluded.

COMPLETE DEEP BITE


An incisor relationship in which lower incisor
contacts the palatal surface of the upper
incisors or the palatal tissue when the teeth
are in centric occlusion.

DENTAL DEEP BITE


It is confined to the dentition where there
is extrusion of anteriors and intrusion of
molars.
Often seen in Angles class II division 2
malocclusion.

Clinical features:
Extra oral features Decreased lower facial height
Intra oral features Increased overbite
Decreased overjet
Extruded maxillary anteriors
Intruded maxillary posteriors
Increased susceptibility to food impaction and resultant
gingivitis in lower anterior region
Cephalometric findings:
Increased interincisal angle

SKELETAL DEEP BITE


Usually of genetic origin caused by
upward & forward rotation of mandible i.e.
counter clockwise rotation of the mandible.
Can also be caused by clockwise rotation
of maxilla or a combination of both.
Skeletal deep bites are seen in Angles
skeletal class II division 2 malocclusion.

Clinical features:
Extra oral feature Decreased lower facial height

Intra oral features Increased overbite


Decreased overjet
Increased risk of gingivitis in the mandibular anterior region

Cephalometric findings Increased ramus height


Decreased FMA angle
Upward & forward rotation of mandible

DIAGNOSIS:
Extraoral & intraoral examinations of the
patient should be thoroughly done &
history of oral habits to be noted
Following diagnostic aids are used:
Clinical examinations
Orthodontic study models- to evaluate extent
of severity of deep bite
Lateral cephalograms- to evaluate ramus
height, interincisal angle & Frankfort
mandibular plane angle.

TREATMENT OF DEEP BITE:


Brought about by maxillary anterior
intrusion, maxillary posterior extrusion,
mandibular anterior intrusion, mandibular
posterior extrusion or combination of
these
Light forces are used for incisor intrusion
whereas heavier forces for extrusion of
posteriors.
Deep bite can be treated by using
removable, myofunctional or fixed

REMOVABLE ORTHODONTIC
APPLIANCES
ANTERIOR BITE PLANE:
Used in conjunction with fixed mechanotherapy
It is the modified version of Hawleys removable
appliance with following features:
Adams clasps on molars- aid in retention of the bite
plane
Labial bow- prevents maxillary anterior proclination
Bite plane should be 1.5-2mm

FLAT ANTERIOR BITE PLANE:


Made up of acrylic base material behind the
maxillary incisors so that the mandibular incisors
touch the bite plane before the buccal teeth
come into occlusion
Used to reduce incisal overbite in Angles class II
division 2 & Angles class I malocclusion
Induces extrusion of upper & lower posteriors
thereby bringing about reduction of the incisal
overbite

INCLINED ANTERIOR BITE PLANE:


Mainly used for correction of deep bite in
Angles Class II division 1 malocclusion.
Induces a forward mandibular posture &
reciprocal backward force on the maxillary
appliance from the masticatory forces &
extrusion of lower posteriors

MYOFUNCTIONAL APPLIANCES
Activator
Bionator
Frankel appliance

FIXED ORTHODONTIC APPLIANCES


The intrusion arches & utility arches when
used bring about correction of deep bites
by intrusion of incisors
Indicated in patients with excessive
maxillary incisor visibility at rest or when
smiling (gummy smile).

UTILITY ARCHES:
Arch wires used with fixed orthodontic appliances.
They are bent in such a way that they bypass the
premolars & are engaged on the incisors.
Activated by giving a V bend in the buccal segment of
the wire mesial to the molar to generate an intrusive
force on the incisors.

ARCH WIRES WITH REVERSE CURVE OF SPEE


USE OF ANCHORAGE BENDS

MANAGEMENT OF DEEP BITE

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