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:
• DEEP BITE

INCOMPLETE 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 Angle’s 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 Angle’s
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
orthodontic appliances
REMOVABLE ORTHODONTIC
APPLIANCES
ANTERIOR BITE PLANE:
• Used in conjunction with fixed mechanotherapy
• It is the modified version of Hawley’s removable
appliance with following features:
• Adam’s 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 Angle’s class
II division 2 & Angle’s 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

Angle’s 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
THANK U!!!