Deep Bite Diagnosis Treatment

This guide organises possible treatment options for a deep bite diagnosis. The document is a treatment planning tool to assist you assist how to best treat patients. Treatments are graded by complexity, ranked by the orthodontic technique required, as a guide to the efficacy of treatment and enable providers to select cases that best matches their ability to apply advanced techniques. In this regard, it is particularly useful for dentists who are just beginning to provide clear aligner treatment.

Disclaimer

As doctors are solely responsible for the treatment they’re providing their patients, they should understand their limits and not hesitate to consult a specialist for further guidance when required. Note when applying this guide only general, high-level information on how each isolated condition might be treated is provided. The relationships between different conditions that exist in the majority of patients are not addressed. In this regard, always consider each patient’s individual dental and periodontal condition, restorative needs, facial proportions, and age when considering treatment options.

Deep Bite

Deep Bite

A common vertical problem is a deep overbite, commonly referred to as deep bite. It is important to correct a deep bite situation because doing so will allow for improved function of the occlusion, such as lateral excursions and protrusive movements. When the mandibular incisor teeth erupt excessively, anterior deep bite problems may result. This is particularly common in Class II malocclusions.

In severe Class II situations the teeth can even erupt into the palatal mucosa. In order to alleviate the problem of over eruption of the lower incisors, the Curve of Spee should be levelled in the lower arch by intruding the over-erupted incisors.

Another cause of deep bite, much more common among adult patients, is the infra-eruption or attrition of posterior teeth. As people age, the effects of parafunctional habits begin to show. Bruxism is a major cause of the aforementioned situation. In addition, a forward and upward rotation of the mandible can cause the deep bite as well.

Unfortunately, most of these occlusions cannot be restored without comprehensive full mouth rehabilitation.

As a result, many patients opt to have limited orthodontic treatment instead, and maintain the existing posterior occlusion.

Supra-eruption of incisors

Intrude incisors with attachments Novice (0-15 cases)

Proligner can predictably intrude incisors, especially lower incisors. The key to intrusion of the lower incisors is having attachments on teeth posterior to the teeth being intruded for retention of the aligner.

Maintain deep bite, aesthetic alignment Novice (0-15 cases)

In certain situations, the patient and clinician may opt to maintain the deep bite. In these cases it is important to inform the patient that although aesthetic alignment will take place, the functional occlusion will be maintained.

Infra-eruption or attrition of posteriors

Maintain deep bite, aesthetic alignment Novice (0-15 cases)

In certain situations, the patient and clinician may opt to maintain the deep bite. In these cases it is important to inform the patient that although aesthetic alignment will take place, the functional occlusion will be maintained.

Alignment by posterior extrusion with auxiliaries Experienced (16-50 cases)

Proligner treatment may also be combined with posterior restorations and/or auxiliary treatment. Posterior extrusion with aligners alone should be avoided, as this is a less predictable movement. When combining restorative treatment with Proligner treatment, it is best to complete the final restoration after the orthodontic component is completed. However, it may be necessary to temporise prior to starting with Proligner in order to achieve adequate crown length. To avoid dislodging the temporary restorations with the aligners, be sure to use a durable cement.

Proligner plus posterior extrusion with auxiliaries Advanced (>50 cases)

Posterior extrusion with auxiliaries may include vertical elastics attached to buttons and reverse curve arch wires secured to brackets. Posterior extrusion with aligners alone should be avoided, as this is a less predictable movement.