Deepbitemalocclusions
Download as PPTX, PDF13 likes1,644 views
This document discusses deep overbite malocclusions. It begins with definitions and classifications of overbites. It notes that overbites greater than 5mm may require correction to prevent trauma. Causes can be skeletal, dental, or soft tissue. Diagnosis involves cephalometric analysis. Treatment principles involve molar extrusion and incisor intrusion using various appliances like bite planes, utility arches, mini-screws and orthognathic surgery in severe cases. Correction is important to prevent dental wear and speech issues.
![Bibliography
• [1] Uribe F,Nanda R. Treatment of Class II Division 2 Malocclusion in Adults: Biomechanical
consideration. 2003; 37 (11):599-606.
• [2] Kim SH, Park YG, Chung K. Severe Class II Anterior bite malocclusion treated with a C-lingual
retractor. Angle Orthod. 2004;74:280-5.
• [3] Nanda R. Correction of deep over bite in adults. Dent Clin North Am. 1997; 41:67–87.
• [4] Dermaut LR, De Pauw G. Biomechanical aspects of Class II mechanics with special emphasis in
deep bite correction as part of the treatment goal. In : Nanda R ed. Biomechanics in clinical
Orthodontics. Philadelphia, Pa: W.B. Saunders Co; 1997:86-98.
• [5] Burstone C. Deep overbite correction by intrusion. Am J Orthod Dentofac Orthop. 1977;72:1-22.
• [6] Nanda, R.; Marzban R.; Kuhlberg, A.; The Connecticut Intrusion arch. J Clin. Orthod. 1998; 32:708-
15.
• [7] Proffit WR. Contemporary orthodontics. 3rd ed. St Louis: Mosby;1999. p. 200-1.
• [8] Horiuch Y,Horiuch M, Soma K. Treatment of severe Class II division 1 deepoverbite malocclusion
without extractions in an adult. Am J Orthod Dentofacial Orthop. 2008; 133(4):S121-9.
• [9] Karanth DHS, Shetty SV. Comparative study of various Intrusion arches. J Ind Orthod Soc.
2001;34:82-91.
• [10] Nanda R, Upadhyay M. Skeletal and dental consideration in orthodontic treatment machanics: a
contemporary view. As cited from URL- http://EJOOxfordJournals. org/. on 24th Oct, 2013.](https://image.slidesharecdn.com/deepbitemalocclusions-151009192215-lva1-app6891-170908092313/85/Deepbitemalocclusions-58-320.jpg)
Deepbitemalocclusions
- 2. Deep Overbite Malocclusion Dr. ABIN MATHEW CIDS
- 3. CONTENTS Deep bite Malocclusions 1-Definition and Prevalence 2Classification of overbite 3Do Deep Overbites require correction? 4- Aetiology and Diagnosis - Deep bite 5-Deep bite Treatment – Complications 6-Biomechanical Considerations 7- articles 8-Conclusion
- 4. 1-Definition -Deep bites Overbite may be defined as the degree of vertical overlap of the mandibular incisors by the maxillary incisors when the posterior teeth are in occlusion. In a Class I incisor relationship the overbite depth is 2–3 mm on average
- 5. 1-Prevalence- Deep bite * The prevalence of deep bite varies between racial groups, example, it is almost twice as common in Caucasian Americans compared to African Americans and Hispanics * 33.1% of cases had overbites of 3-4mm, with 14.2% having 5-7mm overbites. Overbites >7mm were seen in 1.7% of cases. Proffit, Nanda.
- 6. 2-Classification of overbite 2-3-mm Traumatic >7mm Non Traumatic; 5- 7 mm
- 8. 3-Do Deep Overbites require correction ? If not treated, deep bites can result * In trauma to the palatal mucosa, occlusal trauma (1) behind the upper incisors or to the labial gingiva of the lower incisors, root dehiscence (2). *Excessive attrition (3) of anterior teeth, and Bruxism (1) OU AM SA D M MA AB LN
- 9. 3-Do Deep Overbites require correction ? Early treatment unlocking the bite in class II division 2, unlocking mandibular growth, Avoid surgical treatment in adults, Improved smile, esthetic benefits
- 10. 3-Do Deep Overbites require correction ? In children, causes of obstructive sleep apnea often include enlarged tonsils (1) or adenoids and dental conditions such as a large overbite.
- 11. 4- Aetiology and Diagnosis - Deep bites Sassouni & Nanda Environmental and/or genetic factors play a role in the development of deep bites. Individual facial growth patterns to be genetically predetermined. Deep bites can be classified as skeletal, dental or soft tissue.
- 12. 4- Aetiology and Diagnosis - Deep bites Dental Overeruption of the mandibular incisors often accompanies a Class II division 1 malocclusion,or class II divison 2, Deep bites are commonly associated with - An excessive Curve of Spee -Over-eruption of anterior - Infra-occlusion Molars - Lateral tongue posture or lateral tongue thrust, Premature loss of posterior teeth
- 13. 4-Aetiology and Diagnosis- Deep bites Soft tissue An important aetiological factor in Class II division 2 malocclusion is a -High lower lip line, which is thought to guide the maxillary and mandibular incisors to erupt in a more retroclined position. - Reduced lower anterior face height, short face -Increased mentalis muscle activity, A strap-like lower lip , cause retroclination of the mandibular incisors, or if a high lower lip position is also present
- 14. 4- Aetiology and Diagnosis - Deep bites Predisposing characteristics for the development of a Class II, division 2 malocclusion. - a and b A short upper lip. -c A reduced anterior lower facial height with a horizontally orientated mandibular lower border and a small gonial angle. -d An excess of labial soft tissues
- 15. 4- Aetiology and Diagnosis - Deep bites M. ABOULNASER - O.SANDID Skeletal deep bites are charaterised by convergent jaw bases, The maxillary basal bone rotates downwards, i.e,. clockwise rotation, The mandible rotates forwards and upwards i.e., anticlockwise rotation, all four planes of face are horizontal and near parallel to each other, the lower facial height is decreased
- 16. 4-Diagnosis- Deep bites- Cepalometrics analysis Skeletal Deep Bites -Acute cranial base angle -Reduced ratio (proportion of posterior face height to anterior face height) - Reduced Y-axis - Increased ramal length - Parallel Sassouni planes -Forward rotation of the mandible, in the direction of mouth closing -Reduced lower anterior face height - Reduced gonial angle
- 17. Symptoms-Deep bite •1- Jaw pain, Headaches, TMJ pain •2-Teeth grinding, Cementum erosion •2a- Enamel wear contribute to the problem along with slurry speech, particularly among older patients. As the patient gets older the bite gets deeper which makes the malocclusion worse. •- Deep bites interfere with clear speech. •3- Change the structure of the face, mouth and smile. •3a- The shape of the face is short and round and the chin looks too small even when it is actually normal in size. The abnormal teeth alignment contributes to the malocclusion and the shape of the patients face.
- 18. 4-Lips and tongue pressure in orthodontic patients A big factor in the way your teeth grow is their relation to your lips and tongue. BALANCE OF PRESSURE from the lips pushes the teeth inward, while pressure from the tongue pushes the teeth outward, Tokeep your teeth straight, there must be a perfect balance of pressure between these tow forces . ID ID
- 19. 4-Deep bite - Cephalometric evaluation ODI = Overbite DepthIndicator. *FH-FP = Frankfort -facial plane (N-Po). *LP = LabialPosition *EL = EstheticLine. *IIA = Inter incisal Angle -------------------------- O line- MP=20 deg if sup 25 lower incisor intrusion ----------------------- O line –PP =10, If sup 15 deg, upper incisor intrusion ------------------------ Acute cranial base angle ---------------------------- Reduced Y axix ---------------------------- Increased ramal length ----------------------------- Forward growth rotation Md ---------------------------------------- VIRGINIA
- 21. 5-Deep bite Treatment a.Principes: Molar extrusion, Incisor intrusion b.Maxillary and mandibular Connecticut Intrusion Arches c-Rickett’s utility arch d.Burstone’s intrusion arch e.Using reverse-curved archwires f.Deep bite Treatment with mini-scrwes g.Removable appliances- Anterior inclined Bite Plan, Clear Aligner h-Functional appliances , Mandibular advancement, Frankel i.Class II intermaxillary elastics j.Orthognathic surgery K-Cervical pull headgear to maxillary first molars-hooOkUS hAMeA SaANdDIgDear to the upper labial segment 5l-Bite turbo 5m-Lingual technique 5n-Leveling the curve of Spee 50-Deep bite - Bracket Placement
- 22. 5a-Deep bite Treatment a- Principes: Incisor intrusion, Molar extrusion Madhur Upadhyay, Ravindra Nanda Incisor intrusion Molar extrusion
- 23. True intrusion or absolute intrusion refers to the apical movement of the geometric center of the root (centroid) with respect to the occlusal plane or a plane based on the long axis of the tooth. It is an axial type of translation whose center of rotation lies at infinity. Relative intrusion is the one which is achieved by preventing eruption of the incisors, while growth provides vertical space into which the posteriors erupt. Pseudo-intrusion refers to the labial tipping of an incisor around its centroid. INTRUSION
- 25. Amount of intrusion: orthodontically - as given in envelope of discrepancy Maxillary Incisors 2mm Mandibular Incisors 4mm Maxillary Posteriors 3mm Mandibular Posteriors 3mm
- 26. 5b-Deep bite Treatment Intrusion force system consists of anterior intrusive force, posterior extrusive force, and posterior tipback moment. b-Maxillary and mandibular Connecticut Intrusion Arches RAVINDRA NANDA, ROBERT MARZBAN, ANDREW KUHLBERG, JCO, VOLUME 32 : NUMBER 12 : PAGES (708-715) 1998
- 27. 5c-Deep bite Treatment M. ABOULNASER - O.SANDID 5c-Deep bite Treatment c-Rickett’s utility arch
- 28. 5d-Deep bite Treatment5d-Deep bite Treatment D-Burstone’s intrusion arch- 3-pieces
- 29. 5e-Deep bite Treatment-Using reverse-curved archwires Deep bite be treated by extrusion of posterior teeth, intrusion of maxillary and/or mandibular incisors or a combination of procedures Elastics
- 30. 5f-Micro Implants for Intrusion and Retraction Amarnath B.C Prashanth C.S Dharma R.M , IJCD • NOVEMBER, 2010 • 1(2) © 2010 Int. Journal of Contemporary Dentistry
- 31. 5f-Deep bite Treatment with mini-screws Upper and lower incisor intrusion when it is desirable to have these teeth tip buccally. Upper and lower incisor intrusion when it is desirable to maintain teeth’s axial tipping. Telma Martins de Araújo, Mauro Henrique Andrade Nascimento, Dental Press J. Orthod. v.13, no. 5, p. 36-48, Sep./Oct. 2008 A
- 32. 5f-Deep bite Treatment5f-Deep bite Treatment F-Deep bite Treatment with mini-screws Tülin Uğur TANER, Soner KAMACI DDS, Bahadır GİRAY DDS, Hacettepe Dişhekimliği Fakültesi Dergisi Cilt: 31, Sayı: 3, Sayfa: 44-51, 2007 Initial Initial Final Final
- 34. 5f-Deep bite Treatment with mini-screws 5f-Deep bite Treatment with mini-screws
- 35. 5g-Deep bite Treatment Removable appliances- Anterior inclined Bite Plan Overbite correction with Removable Appliances, the posterior teeth should be separated by about 2-3 mm- anterior bite plane that causes a posterior disclusion
- 36. 5g-Deep bite Treatment http://orthocj.com/2011/03/a-new-fixed-acrylic-bite-plane-for-deep-bite-correction/ Pre-treatment With fixed biteplane Occlusal view Post-treatment Fixed Acrylic Bite Plane for Deep Bite Correction
- 37. 5g-Deep bite Treatment5g-Deep bite Treatment Deep-Bite Correction Using a Clear Aligner and Intramaxillary Elastics JAE HYUN PARK, TAE WEON KIM, JCO/MARCH 2009 Initial Final
- 38. 5h-Deep bite Treatment Functional appliances, Mandibular advancement, Frankel Before After
- 39. 5h-Early Treatment of A Class II, Division 2 Malocclusion Trainer for Kids (T4K) ALHUSSAIN IBRAHIM ORTHODONTIST USA VIRGI Myobrace is a no-braces orthodontic approach to help straighten your teeth and jaws. Treatment addresses the poor oral habits that are the real cause of crooked teeth.
- 42. 5h-Deep bite Treatment Aditya Chhibber, Madhur Upadhyay, Ravindra Nanda,http://www.orthodonticproductsonline.com/ Twin Force Bite Corrector Intial Final
- 43. 5j-Deep bite Treatment Maurice Y.Mommaerts, Evelyn Asselman, Orthognathic surgery, Class II, deep bIte, prominent Chin Intial Final
- 44. Management of Skeletal Class II, deep bite
- 46. 5 k-Deep bite Treatment http://www.angle.org/doi/pdf/10.1043/0003-3219%282004%29074%3C0480%3ATROAHP%3E2.0.CO%3B2 K-hook headgear to the upper labial segment
- 47. 5k-Deep bite Treatment Amarnath B.C Prashanth C.S Dharma R.M , IJCD • NOVEMBER, 2010 • 1(2) © 2010 Int. Journal of Contemporary Dentistry k-hook headgear to the upper labial segment
- 48. 5l-Bite turbos
- 50. 5n-Deep bite Treatment Leveling the curve of Spee Extrusion of molars and resultant downward and backward mandibular rotation (solid line = pre-treatment; dotted line = post-treatment)
- 51. Complications -Intrusion in Orthodontics and root resorption
- 52. 5(o)-Deep bite - Bracket Placement
- 53. 6-Biomechanical Considerations FLAVIO URIBE, RAVINDRA NANDA, VOLUME XXXVII NUMBER 11 © 2003 JCO, Inc. Intrusion arch produces anterior tipback moment and intrusive force along with extrusive force on molars.
- 54. Biomechanical Considerations FLAVIO URIBE, RAVINDRA NANDA, VOLUME XXXVII NUMBER 11 © 2003 JCO, Inc. .017" × .025" CNA mushroom-loop archwire after intraoral activation.
- 55. Mini-Screw for Deep Bite Correction: A Prospective Clinical Trial IOSR Journal of Dental and Medical Sciences El Namrawy MM1 , Sharaby FA2 , Bushnak MA3 1,2,3(Department of Orthodontics, College of Oral and Dental medicine /Cairo University, Egypt The sample comprised of 15 post pubertal patients (6 females and 9 males) with mean age 19.5 ± 2.5. They underwent maxillary incisors intrusion using miniscrews. Pre and post treatment lateral cephalometric x-rays and study models were made to evaluate the dento-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 (0.49mm per month) and the mean amount of incisors retraction was 1.5± 0.9. Although there was statistically significant decrease in the mean overbite, no significant changes were found in skeletal, soft tissue and intermolar width measurements. Conclusion:Intrusion of maxillary incisors was effective in treatment of deep bite and gummy smile caused by over eruption of upper molars. Molar anchorage was conserved despite constriction of inter canine area.
- 56. Stability and relapse after orthodontic treatment of deep bite cases—a long-term follow-up study J. C. Danz*, C. Greuter*, l. Sifakakis**, M. Fayed***, N. Pandis* and C. Katsaros* *Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland European Journal of Orthodontics 36 (2014) 522–530 The purpose of this long-term follow-up study was twofold—firstly, to assess prevalence of relapse after treatment of deep bite malocclusion and secondly, to identify risk factors that predispose patients with deep bite malocclusion to relapse. Sixty-one former patients with overbite more than 50% incisor overlap before treatment were successfully recalled. Clinical data, morphometrical measurements on plaster casts before treatment, after treatment and at long-term follow-up, as well as cephalometric measurements before and after treatment were collected. The median follow-up period was 11.9 years. Patients were treated by various treatment modalities, and the majority of patients received at least a lower fixed retainer and an upper removable bite plate during retention. Relapse was defined as increase in incisor overlap from below 50% after treatment to equal or more than 50% incisor overlap at long-term follow-up. Ten per cent of the patients showed relapse to equal or larger than 50% incisor overlap, and their amount of overbite increase was low. Among all cases with deep bite at follow-up, gingival contact and palatal impingement were more prevalent in partially corrected noncompliant cases than in relapse cases. In this sample, prevalence and amount of relapse were too low to identify risk factors of relapse.
- 57. Conclusion • Uncorrected deep bites may lead to loss of tooth structure due to attrition, as well as periodontal compromise due to traumatic occlusion and impingement. • It is important to assess the patient facially, skeletally and dentally to ensure correct diagnosis of the vertical dimension. Identification of the aetiology of the deep bite will allow formulation of appropriate treatment mechanics.
- 58. Bibliography • [1] Uribe F,Nanda R. Treatment of Class II Division 2 Malocclusion in Adults: Biomechanical consideration. 2003; 37 (11):599-606. • [2] Kim SH, Park YG, Chung K. Severe Class II Anterior bite malocclusion treated with a C-lingual retractor. Angle Orthod. 2004;74:280-5. • [3] Nanda R. Correction of deep over bite in adults. Dent Clin North Am. 1997; 41:67–87. • [4] Dermaut LR, De Pauw G. Biomechanical aspects of Class II mechanics with special emphasis in deep bite correction as part of the treatment goal. In : Nanda R ed. Biomechanics in clinical Orthodontics. Philadelphia, Pa: W.B. Saunders Co; 1997:86-98. • [5] Burstone C. Deep overbite correction by intrusion. Am J Orthod Dentofac Orthop. 1977;72:1-22. • [6] Nanda, R.; Marzban R.; Kuhlberg, A.; The Connecticut Intrusion arch. J Clin. Orthod. 1998; 32:708- 15. • [7] Proffit WR. Contemporary orthodontics. 3rd ed. St Louis: Mosby;1999. p. 200-1. • [8] Horiuch Y,Horiuch M, Soma K. Treatment of severe Class II division 1 deepoverbite malocclusion without extractions in an adult. Am J Orthod Dentofacial Orthop. 2008; 133(4):S121-9. • [9] Karanth DHS, Shetty SV. Comparative study of various Intrusion arches. J Ind Orthod Soc. 2001;34:82-91. • [10] Nanda R, Upadhyay M. Skeletal and dental consideration in orthodontic treatment machanics: a contemporary view. As cited from URL- http://EJOOxfordJournals. org/. on 24th Oct, 2013.
Editor's Notes
- #55: 3nitroaniline 2 chhloro 4nitroaniline alloy