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PubMed1990

[The treatment of deep bite in adults].

UNLABELLED: 49 treated adult patients with deep-bite were classified by analysing orthodontic models and lateral cephalograms differentiating skeletal, dento-alveolar deep-bite and class I, class II-1, class II-2 malocclusion. Change of overbite and position of incisors were described within every group and compared with the other groups. RESULTS: On the average overbite decreased about 3.5 mm, mostly however combined with root resorptions in the maxillary front. After removing the appliance overbite relapsed about 1.7 mm at 93.3% of cases. The percentage of factors which made possible a decrease of overbite was described and parameters which caused the relapse were discussed. Interpreting the results of orthodontic treatment in adults, it seems to be legitimized in some exactly indicated cases but, treatment in adults is not the best time for correcting deep-bite.

Adult↗
PubMed1996

Skeletal and dentoalveolar changes after extraction of the second molars in the upper jaw.

The aim of this study was to evaluate treatment results after extraction of maxillary second molars. Since this therapy was chosen in patients with class II malocclusion, deep overbite and counterclockwise growth pattern, its effects on overbite and correction of the malocclusion were examined. For this purpose pre- and post-treatment models of 25 patients with 48 extracted upper second molars were measured and lateral cephalograms were appropriately superimposed in order to determine maxillary and mandibular skeletal and dentoalveolar changes. Our results indicate an average overbite reduction from 4.7 mm to 2.7 mm. None of the patients showed a posttreatment overbite increase. Despite the considerable initial Class II relation in many cases, a Class I occlusion was achieved in 92% of the patients. Primarily, the correction was achieved by distalization of the upper first molars. Furthermore, the mesial migration of the lower first molars, skeletal changes in the lower jaw, and the growth inhibition in the upper jaw contributed to the correction of the class II malocclusion.

Adolescent↗
PubMed1992

[The functional treatment of deep bite--the results of a long-term study].

The amount of overbite reduction and the stability of the results three to 14.5 years post-retention were analysed in a follow-up study of 60 patients who had been treated with functional appliances. To establish therapeutic and posttherapeutic changes in dento-facial relationships, plaster casts and lateral cephalograms were evaluated at the beginning, at the end of treatment and at the follow-up examination. Posttherapeutic deepening of the overbite (> 0.8 mm) was found in 54.2% of the cases, while overbite reduction remained stable in 39%. A number of skeletal and dental factors were found to be involved in overbite reduction and posttreatment deepening. In this connection, changes in the ML-NSL angle, the ML-NL angle and the gonion angle were found to be just as important as the therapeutic and posttherapeutic changes in anterior and posterior facial height and changes in the skeletal pattern. It is emphasized that strict application of retention is of the greatest importance to minimize vertical relapse.

Adolescent↗
PubMed2005

Retrospective analysis of casts to assess cervical headgear treatment in the presence of vertical growth pattern.

OBJECTIVE: Does molar distalization as effected by cervical headgear increase the vertical dimension of occlusion in patients with vertical growth pattern? MATERIALS AND METHODS: A sample of 86 patients with neutral and vertical growth pattern in the late mixed dentition stage underwent headgear treatment. Their initial and intermediary casts were retrospectively analyzed for occlusal relationships at the maxillary first molars and degrees of overjet and overbite. The only cases included were those in which headgear treatment was carried on for at least 6 months, achieving a minimum distalization of 4 mm. The intermediary casts were fabricated after headgear treatment had been completed and prior to the initiation of multiband treatment. Patients were divided into three groups (N, V1 and V2) according to the degrees of vertical growth pattern, which were determined based on y-axis angle values. RESULTS: Grouped by degrees of vertical growth, the data revealed occlusal relationship changes of 6-8 mm and overjet reductions of 0.6-1.2 mm. The overbite changes were unexpectedly small (0-0.04 mm). Grouped by degrees of overbite, the data revealed that headgear treatment increased the vertical dimension of occlusion in deep-bite patients (>4 mm), while giving rise to decreases in patients with overbites of <3 mm.

Adolescent↗
PubMed1984

Components of adult Class III open-bite malocclusion.

In an effort to identify the frequency and differences in the dental and skeletal components of a large sample of adults with Class III malocclusion, with and without open bite, 176 subjects, one half of whom had an anterior open bite, were evaluated. These subjects were chosen by looking at the lateral cephalometric radiographs that were taken of 302 adults (128 men and 174 women) who exhibited at least an end-to-end Class III molar and canine relationship. The dental overbite was calculated for all subjects, and those with a negative overbite were placed in the open-bite (OB) group. Those with a positive overbite were placed in the non-open-bite (non-OB) group. The dental overbite was the only criterion used to define the open-bite and non-open-bite groups. The open-bite subjects were paired with a non-open-bite subject by sex, presence of presurgical orthodontic treatment, and anterior cranial base length. Eighty-eight subjects in each group (43 men and 45 women) were obtained. Various measures of craniofacial structure were calculated and analyzed by comparing the OB and non-OB groups with the paired t test. The areas that showed significant differences (p less than 0.05) between the OB and non-OB groups were as follows: the posterior maxilla exhibited vertical excess in the OB group; the maxillary occlusal plane was less steep in the OB group; the mandibular occlusal plane was more steep in the OB group; the gonial angle was higher in the OB group; the mandibular plane angle was higher in the OB group; the mandibular ramus was positioned in a more downward and backward location in the OB group; the total anterior facial height and lower facial height were increased in the OB group; the vertical height of the anterior maxilla was increased in the OB group; and the mandible was less protrusive in the OB group. No significant intergroup differences were noted in the cranial base, the anteroposterior position of the maxilla or the upper and lower incisors, the palatal plane, posterior facial height, mandibular ramus height, or mandibular body height. The results of this analysis indicate that the average Class III open-bite malocclusion is characterized by aberrations in both the maxilla and the mandible. Surgical therapy may, therefore, require intervention in both jaws to correct this deformity successfully.

Adolescent↗
PubMed2006

Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 1. Cephalometric analysis.

INTRODUCTION: Oral appliances (OAs) have been widely used to treat snoring and sleep apnea, but their effects on craniofacial structures in patients after 5 years or more of wear have not yet been quantified. METHODS: Seventy-one patients who had worn adjustable mandibular repositioners to treat snoring or sleep apnea were evaluated. Upright lateral cephalometric radiographs in centric occlusion taken before treatment and after a mean of 7.3 +/- 2.1 years of OA use were compared. Baseline sleep studies and patient demographic data were included in the analysis. RESULTS: Cephalometric analyses after long term OA use showed significant (P < .01) changes in many variables, including increases in mandibular plane and ANB angles; decreases in overbite and overjet; retroclined maxillary incisors; proclined mandibular incisors; increased lower facial height; and distally tipped maxillary molars with mesially tipped and erupted mandibular molars. The initial deep overbite group had a significantly greater decrease in overbite. Duration of OA use correlated positively with variables such as decreased overbite and increased mandibular plane angle; changes in the dentition appeared to be progressive over time. CONCLUSIONS: After long-term use, OAs appear to cause changes in tooth positions that also might affect mandibular posture.

Analysis of Variance↗
PubMed1999

The compensatory mechanism in high-angle malocclusions: a comparison of subjects in the mixed and permanent dentition.

Dentoskeletal morphology was assessed in 191 untreated and unselected children with a hyperdivergent (high-angle) mandibular plane (ML/NSL > or =40 degrees) by analyzing lateral roentgenographic cephalograms. The subjects were divided into mixed dentition and permanent dentition groups, and further divided into subgroups based on the amount of overbite (OB) as a measure of dentoalveolar compensation of jaw base hyperdivergency: OB < 0 mm (openbite) = insufficient/no compensation; OB 0 to 4 mm (normal overbite) = acceptable compensation; OB > 4 mm (deepbite) = overcompensation. Openbite was observed in 20% of the children, normal overbite in 50%, and deepbite in 30%. Skeletally, the deepbite mixed dentition group was characterized by a relatively posterior inclination of the maxilla, while the deepbite permanent dentition group had a relatively anterior inclination of the mandible. Dentoalveolar compensation was accomplished by relative increases in maxillary and mandibular anterior dentoalveolar heights in the mixed dentition group and by relative decreases in maxillary and mandibular posterior dentoalveolar heights in the permanent dentition. Positive overbite was found in the majority (80%) of children with high-angle morphology. Thus, mandibular hyperdivergency is frequently compensated for. Skeletal characteristics and dentoalveolar compensatory mechanisms differ with dental maturity and seem to be influenced by mouth breathing and other oral habits.

Age Factors↗
PubMed2002

Long-term stability of the leveling of the curve of Spee.

The aim of the study was to investigate whether the orthodontic leveling of the curve of Spee is a treatment procedure with a stable result on a long-term basis. Measurements were made on the plaster casts of 149 orthodontically treated patients (57 males and 92 females). The mean age before treatment was 12.8 years (range, 8-25 years). Study casts were taken before treatment (T1), at the completion of orthodontic therapy (T2), and 6.7 years (mean) posttreatment (T3). Inclusion criteria were no extractions, all Angle classifications except Class III malocclusions, and all permanent teeth fully erupted except second and third molars. The curve of Spee and the irregularity index were measured on standardized digital photographs of the casts. Overjet and overbite were assessed with a ruler. Changes in the curve of Spee were correlated with changes in irregularity index, overjet, and overbite from T1 to T3. The following results were noted: (1) leveling of the curve of Spee is a relatively stable treatment procedure compared with a return of incisor crowding and deepening of the bite; (2) neither the initial depth of the curve of Spee nor the initial irregularity index is an indicator for the amount of relapse; (3) the amount of leveling is not correlated with the relapse of the 4 tested parameters (curve of Spee, irregularity index, overjet, and overbite); and (4) there is a mild correlation between the relapse of the curve of Spee and the relapse of the irregularity index, overjet, and overbite. According to the results of the study, leveling the curve of Spee during orthodontic treatment seems to be very stable on a long-term basis; it was weakly correlated with the other variables tested.

Adolescent↗
PubMed2002

Dental arch width in Class II Division 2 deep-bite malocclusion.

A severe phenotype of Angle's Class II Division 2 (II/2) malocclusion with extremely deep overbite has been called cover-bite, or "Deckbiss" in its early German descriptions. This distinctive occlusal variation is characterized by skeletofacial hypodivergence, mandibular dentoalveolar retrusion, excessive bony chin projection, reduced mesiodistal tooth size, maxillary incisor retroclination, and at least 100% overbite, covering at least 1 mandibular incisor in occlusion. In this study, maxillary and mandibular dental arch widths measured at the first molars and the canines were recorded from dental casts of 23 subjects with II/2 cover-bite malocclusions. The data were compared with a control-reference sample of 46 orthodontic patients matched for age and gender. In the cover-bite group, the intermolar widths in both arches and the intercanine width in the maxilla were comparable with those in the control sample. However, mandibular intercanine width in the II/2 cover-bite group was significantly less than that of the controls (P =.01). These findings suggest that II/2 deep overbite malocclusion is characterized by normalized and relatively compatible transverse dimensions in the maxilla and in the mandibular posterior segments. The transverse underdevelopment that this study identified in the mandible from canine to canine is probably responsible for mandibular incisor compression and crowding--natural sequelae of the deep overbite in II/2 cover-bite. Thus, a reasonable orthodontic treatment plan for the mandibular dentoalveolar compensation often seen in II/2 deep-bite patients would be anterior expansion of the mandibular arch width, usually reducing the need for orthodontic tooth extractions and increasing the desirability of fixed retention.

Adolescent↗
PubMed2003

Dental and occlusal changes during mandibular advancement splint therapy in sleep disordered patients.

The aims of this longitudinal, observational study were two-fold: first, to determine in adults with sleep disorders the extent of dental and occlusal changes following the use of a mandibular advancement splint (MAS) and, second, to determine the time course of these changes. One hundred adult subjects (87 males, 13 females) diagnosed with obstructive sleep apnoea (OSA) and/or asymptomatic snoring were treated with non-adjustable MAS. At the outset each subject was randomly assigned to a group and reviewed 6, 12, 18, 24 or 30 months after placement of a splint. There were 20 subjects in each group. Craniofacial changes were measured on lateral cephalometric radiographs taken at the initial and review appointments. When the changes in all subjects were examined, the SNA, ANB angles, ANS-PNS length and face height increased, and the mandibular first molars and the maxillary first premolars significantly overerupted. Significant retroclination of the maxillary incisors and proclination of the mandibular incisors were accompanied by reductions in maxillary arch length, overbite and overjet. When the changes over time were determined, the mandibular symphysis was significantly lower at all review periods. An increase in face height and reductions in overbite and overjet were evident at 6 months, and over-eruption of the maxillary first premolars and mandibular first molars, and proclination of the lower incisors were found at 24 months. Significant positive correlations were also found between the amount of anterior opening by the appliances and changes in overbite at 24 and 30 months. The appliance used produced small, unpredictable changes in the occlusion that tended to occur after 24 months' wear. It is postulated that the changes in overbite might be lessened by keeping the bite opening to a minimum.

Adult↗
PubMed2005

Prevalence and distribution by gender of occlusal characteristics in a sample of Italian secondary school students: a cross-sectional study.

The aim of this study was to describe the prevalence and distribution, by gender, of occlusal traits in a sample of Italian students aged 11-14 years (mean 13 +/- 1 years). Using standardized and validated recording criteria, a single operator measured the overjet, overbite, open bite, anterior and posterior crossbites, crowding, coincidence of the upper and lower midlines, and diastema, in 810 secondary school students (53.6 per cent males). Chi-square, t-test statistics, and odds ratios (ORs) with 95 per cent confidence intervals (CI) were used to investigate the relationship between gender and malocclusion characteristic. Logistic regression was used to further analyse the independent association between gender and each outcome measure. Ninety-three per cent of the subjects showed at least one occlusal trait, with one or two anomalies recorded in 63 per cent of children. The prevalence of occlusal traits ranged from 1.1 (negative overjet) to 54 per cent (upper and lower midlines not coincident). Males were more likely than females to show both an increased overbite and an increased overjet, although the latter result was not confirmed by logistic regression (P = 0.05). Multivariate analysis showed a negative association between overbite and misalignment of the lower incisors and lack of coincidence of the upper and lower midlines, whereas subjects with an increased overbite were more likely to have an increased overjet (all P < 0.01). Further studies are required in order to further clarify these findings and to provide accurate estimates of the orthodontic treatment need in Italian adolescents.

Adolescent↗
PubMed2006

Long-term follow-up of orthodontically treated deep bite patients.

The aim of this study was to evaluate the long-term stability of corrected deep bite and mandibular anterior crowding in a sample of 62 subjects (30 patients and 32 controls). The patients began treatment at a mean age of 12.2 years (SD 1.56). The treatment consisted of non-extraction and fixed appliances in 23 subjects and functional appliances in seven. The treatment group was compared with the control group with normal molar occlusion, normal overjet and overbite, no crowding, and without an orthodontic treatment need. The registrations were made on four occasions: before treatment (T1), after treatment (T2), and at two long-term follow-ups (T3 and T4). Four registrations were also made in the control group. All measurements were undertaken on plaster models and lateral cephalograms. Treatment was found to have normalized the overbite and overjet and to have eliminated the space deficiency in the mandibular anterior region. At T4, there was a minor relapse in overbite in the treatment group (mean 0.8 mm). In the control group, the overbite underwent reverse development (bite opening by 0.7 mm) during the same period. The available mandibular incisor space, however, was -0.9 mm in the treatment group and -1.8 mm in the control group. The long-term stability of the treatment results was thus good.

Adolescent↗
PubMed1996

Prevalence and distribution of selected occlusal characteristics in the US population, 1988-1991.

The inclusion of occusal traits as part of the oral health component of the Third National Health and Nutrition Examination Survey, Phase 1, 1988-91, provided an opportunity to assess several occlusal characteristics in the US population: diastema > or = 2 mm, alignment of lower and upper anterior teeth, posterior crossbite, overbite, and overjet. Household questionnaires asked whether the individual had ever received orthodontic treatment. Prevalence of clinical measures of occlusal characteristics and orthodontic treatment was estimated for over 7,000 sample persons from 8 to 50 years of age, representing approximately 150 million non-institutionalized people in the United States. These findings present the first estimates of occlusal status of the US non-institutionalized population in more than 25 years. Eight percent of the population had severe overbite of 6 mm or more. The average overbite was 2.9 mm. Maxillary diastemas > or = 2 mm were observed in 19% of 8-11-year-olds, 6% of 12-17-year-olds, and 5% of adults 18-50 years old. Twenty-five percent and 22% of persons had zero mm of malalignment in maxillary and mandibular incisors, respectively. Conversely, 11% and 15% of persons had 6 mm or more displacement of maxillary and mandibular molars, respectively. Posterior crossbite affects less than 10% of this population, and less than 10% had overjet of 6 mm or more. Non-Hispanic black adults had the least amount of malalignment in mandibular incisors. Three times as many non-Hispanic blacks compared with non-Hispanic whites and Mexican-Americans had diastemas > or = 2 mm. Comparisons with published data from the National Health Examination Survey (1966-70) indicated a 20% increase of 12-17-year-olds with overbite in the normal range (0-3 mm). Almost 20% of adults ages 18-50, as well as 18% of children, have had orthodontic treatment.

Adolescent↗
PubMed2000

A cephalometric study of the effect of extraction of lower first permanent molars.

The sample consisted of 28 patients (16 female: 12 male) from the records of the Orthodontic Department for whom the extraction of both lower first permanent molars was considered due to caries. The age ranged from 8-14 years (mean age 12.4). A cephalometric radiograph was taken prior to the extraction and after a mean of 18 months. No other treatment was done during the observation period. The radiographs were traced arid digitized using the GeLa program. A total of 16 points were digitized yielding 19 measurements (7 angular and 12 linear). The data were analyzed using 't' test and Pearson Correlation Coefficients in SPSS PC and compared to a control group matched for age and sex. Results showed that on average, the lower second molar moved forwards 5.9 mm. On average there was no change in angulation of the incisors to the bases. There was no significant change in the vertical relations of the jaws save that caused by normal growth and development. A significant correlation was found between the change in overbite and original overbite (r = -0.55, P < 0.01), the change in Li/A-Pog (r = 0.41, P < 0.05) and the change in facial proportions (r = -0.59, P < 0.001). The change in overjet was correlated with the change in Li/A-Pog (r = 0.58, P < 0.001) and change in Li/mand (r = -0.55, P < 0.01). The extraction of the lower first molars results in deepening of the overbite on average, but has no effect on the anterior facial height or any other vertical relationship. However, the increase in overbite is associated with lingual positioning of the lower incisor and the change in facial proportions. The change in overjet is related to lingual positioning and retroclination of the lower incisors.

Adolescent↗
PubMed1992

[Dento-facial structural characteristics in Angle Class II malocclusion associated with abnormal facial divergency].

Lateral cephalometric radiographs of 60 adult patients with Angle class 11 malocclusion associated with abnormal facial divergency were collected from the Orthodontic Department of the National Taiwan University Hospital. They were divided into a hyperdivergent group (35 cases) and a hypodivergent group (25 case), according to mandibular plane angle (SN-MP). The 19 landmarks on each cephalometric tracing were digitized into a computer, then computer-aided cephalometric analysis was performed to calculate the 17 skeletal measurements and 13 dentoalveolar measurements. The dento-facial structural characteristics of the hyperdivergent and hypodivergent groups were compared. It was found that the subjects of the hyperdivergent group revealed a greater tendency of divergency in the anterior cranial base plane, Frank-fort horizontal plane, palatal plane, occlusal plane, and mandibular plane. Hyperdivergent facial type, supposedly indicating an open bite or a tendency toward an open bite, has a longer lower anterior facial height, shorter posterior facial height, longer upper anterior and posterior dental height. While, the majority of dentofacial characteristics of the hypodivergent facial type observed in is study were directly opposite to those of the hyperdivergent facial type. The relationships of incisor overbite depth and other skeletal and dentoalveolar parameters were illustrated by Pearson's correlation coefficient and stepwise multiple regression analysis by means of the SPSS/PC statistic program. With the incisor overbite depth as the dependent variable, the independent variables included on the regression analysis were the 10 items of skeletal and dentoalveolar parameters. The compared parameters showed a statistically significant correlation with the incisor overbite depth (P < 0.001). By the stepwise method, the variables included on the regression equation were (1) N-Go-Gn, (2) A-Gn-Ar, (3) N-Ans/ans-Me, and (4) U1L1. The value of R square (R2) in the regression analysis was 0.543. It demonstrated that only a 54.3% variation in incisor overbite depth can be explained by variations in those skeletal and dentoalveolar variables.

Adult↗
PubMedDate not supplied

[Malocclusion in the primary dentition].

In this paper we analyze the type and frequency of malocclusions in a group of 100 health children with complete primary dentition. Bjork's method for epidemiological registration was taken as a basis. Of the examined children, 78% had some malocclusion type. The most frequent was the increased horizontal overbite. In vertical overbite relation we find anterior open bite, increased overbite, anterior open bite, increased overbite.

Child, Preschool↗
PubMed1989

[Longitudinal changes in the dentition of the deciduous reversed bite using plaster casts].

It is known that some of the deciduous reversed bite cases are corrected spontaneously by themselves. No decisive conclusion, however, has been achieved so far as to what morphological characteristics the self corrected cases have. The purpose of this study, therefore, was to determine whether the difference between the self corrected group (n) and the non-self corrected group (r) exists at their initial examination or if it occurs as a result of changes in occlusion. The materials used in this study were the serial plaster casts of 29 Japanese girls with the deciduous reversed bite at their first visit and these were measured with the three dimensional measurement system. The following results were obtained: 1. Characteristics of the initial examination with the n group: Overjet (-) and overbite in the n group were smaller than in the r group. The arch length and the perimeter of the maxillary dentition in the n group were longer, and the area of the incisive bone (U-C) was wider than in the r group. Moreover, the upper and lower canines in almost all of the n group cases were not touching each other and did not restrict mandibular movement, resulting in easy attrition for the deciduous anterior dentition. 2. Longitudinal changes in the n group: Mean change of this group showed a decrease in overbite caused by the attrition of the deciduous central incisors and the continuous eruption of the maxillary second deciduous molars. Overjet also decreased, because of an increase in the maxillary anterior arch length and of backward movement in the mandibular dental arch. Individual changes were much alike in mean changes in almost all of the measured items. Arch width between canines in the maxilla and arch length in the mandible decreased in some cases, suggesting that a discrepancy would occur when the permanent incisors erupt. 3. Longitudinal changes of the r group: Mean changes showed that overbite decreased in the same pattern as the n group, but overjet did not change and the mandible did not show backward movement. The reason was that overbite in this group was deeper than in the n group at the initial examination. Moreover, deciduous molar to molar width became wider to compensate the decrease in the arch length and the perimeter. Individual changes showed that some of the r group cases had a tendency to improve, but some became worse.

Female↗
PubMedDate not supplied

[Deep bite].

The author emphasizes that the overbite is a component of a lot of malocclusions, but he thinks that it doesn't exist standard values of overbite for all the people. The value would adapt to the patient's feature. He analyses dental movements, for the overbite correction, and skeletal features that allow them or not. The author suggests an overbite classification that depends on functional noise, skeletal noise, clinical noise and aesthetics noise. At least, it's underlined that this malocclusion must ever be overcorrected, and it's taken in consideration that differences between physiologic recovery and relapse.

Auscultation↗