Management Of Open Bite And Deep Bite Question And Answers

Management Of Open Bite And Deep Bite

• Excessive vertical overlapping of the mandibular anterior by maxillary anteriors is called deep bite.
• Deep bite can be skeletal or dental type. Deep bite is a condition of excessive overbite, where the vertical measurement between maxillary and mandibular incisal margins is excessive when mandible is brought into the habitual or centric occlusion.

• Due to supraeruption of anteriors.
• Infraocclusion of molars.
• Due to premature loss of permanent teeth which leads to lingual collapse of anterior teeth.
• Due to tipping of posterior teeth.
• Macrodontia can also lead to deep bite.
• Horizontal growth pattern.
• Short anterior facial height.
• Posterior facial height is long.
• Upper facial height to lower facial height decreases.
• Interocclusal clearance is small.

“Common challenges in managing open bite and deep bite effectively: FAQs provided”

• Anterior bite plane is the most commonly used appliance for treating the deep bite.
• Anterior bite plane is the modifid Hawley’s appliance with the flat ledge of an acrylic behind maxillary anteriors.
• As patient bites, mandibular incisors contact the bite planeand disclose the posteriors which are free to erupt.
• Height of anterior bite plane is just enough to separate the posteriors by 1.5 to 2 mm as posterior teeth erupts the height of bite plane increases.

• Deep bite due to the infra-occlusion of molars can be treated by using the activator or the bionator.
• Design of the functional appliance is modified to allow extrusion of posterior teeth.

• Anchorage bends should be given in arch wire mesial to the molar tubes so the anterior part of arch wire lies gingival to the bracket slot.
• When the arch wires are pulled occlusally and engaged inside the brackets, a gingivally directed intrusive force is exerted on the incisors, which decreases the deep bite.

• They intrude the anterior teeth.
• When there wires are inserted in molar tubes, anterior segment curves gingivally.
• Anterior segment is forced occlusally inside the bracket slot resulting in an intrusive force on incisors.

• Intrusion arch consists of two posterior stabilizing units in buccal segments which are made up of .0175 × .025 inch stainless steel wire.
• Anterior segment which consists of incisors is given a segmental wire of similar diameter.
• Intrusion arch is cantilever types of spring which is inserted into the auxiliary tube of molar tube and bypasses the premolars and the canines.
• It should given a 30 degree bend anterior to molar tube so that its anterior segment lies passively at depth of vestibule.
• Anterior segment is brought down incisally and is tied to anterior segment arch wire which causes intrusion of anteriors.

• Deep overbite due to overeruption of maxillary anterior teeth and be corrected by high pull headgear attached to the anterior segment of arch wire in attempt to intrude these teeth.
• Cervical headgear with downward vector if force increase lower facial height by extruding the molars.

• Maxillary incisors are intruded by placing temporary anchorage devices or mini screws between upper lateral incisors and canines.
• Placement of these mini screws is delayed till leveling and alignment is complete to enable the adequate interradicular bone at the site of their placement.