http://orthocj.

com/2011/03/a-new-fixed-acrylic-bite-plane-for-deep-bite-correction/

A New Fixed Acrylic Bite Plane for Deep Bite Correction
1. Dr. Amit Prakash
Senior lecturer
Department of Orthodontics and Dentofacial Orthopedics
Darshan dental college and hospital, Loyara, Udaipur
2. Dr. Arundhati P. Tandur
Professor
Department of Orthodontics and Dentofacial Orthopedics
K.L.E.S Institute of Dental Sciences, Bangalore
3. Dr.Sri Chandana
Final year PG student
Department of Conservative dentistry
Government dental college, Hyderabad
4. Dr.pravin Murare
Final year PG student
Department of Orthodontics
K.L.E.S Institute of Dental Sciences, Bangalore
Corresponding address
Dr. Amit Prakash
Department of Orthodontics and Dentofacial Orthopedics
Darshan dental college and hospital, Loyara, Udaipur
E-mail address- drprakash24@yahoo.co.in
amitprakash30@gmail.com
Mobile number 09649671900
Abstract
A deep bite is one of the most common malocclusions seen in children and adults that can occur along with other
associated malocclusions. A deep overbite can be corrected by different methods like intrusion of anteriors,
extrusion of posteriors, combination of anterior intrusion and posterior extrusion, proclining anteriors or surgical
correction. However, it should be decided which method will be more beneficial or which will improve the
patients facial appearance and functional efficacy. In this paper a new fixed acrylic bite plane was used to correct
the deep bite by extrusion of molars.

Graber
1
defined overbite as the distance, which the maxillary incisor margin closes vertically past the
mandibular incisor margin, when the teeth are brought into habitual or centric occlusion.
Proffit
2
defined overbite as the vertical overlap of the incisor teeth when the posterior teeth are in contact.
Different terms used for deep bite
Deep overbite
Cover bite
Close bite
Deckbiss
Posterior collapsed bite
Diagnosis
An anterior deep bite could be caused by supraeruption of upper and / or lower incisors or infraeruption of
posterior teeth. To evaluate whether infraeruption or supraeruption is present, the orthodontist must use linear
measurements from the base of the alveolar process. The amount of eruption anteriorly or posteriorly can be
established by Cephalometric analysis.
Bite plane or bite plate
The bite plate was used in 1879 by Miller
3
to permit the elongation of posterior teeth. It has played an important
part in the treatment of the deep overbite ever since. A bite plane can achieve vertical height without significantly
changing the occlusal relationships. In bite plane therapy for the deep overbite the elongation of posterior
segments depends on the growth of the alveolar bone. This new bone must be conditioned to withstand the
stresses of mastication by gradual withdrawal of a bite plate. Many cases of failure of bite plate therapy have been
caused by the abrupt removal of the bite plate before complete organization of the bone has taken place. A bite
plane takes the form of a thickened platform of acrylic, palatal to the upper incisors, on which the lower incisors
can occlude, leaving the posterior teeth out of occlusion.
Extrusion of posterior teeth
Extrusion of posterior teeth is commonly indicated in patients with decreased lower anterior facial height. It is
also indicated in true deep bite cases.
4
If the incisal edges of the maxillary anterior teeth are positioned above the
inferior margin of the upper lip, in these cases extrusion of the posterior teeth is indicated. Extrusion of molars of
an average of 1mm results in 2 to 2.5 mm of bite opening. This is probably the most common and easiest,
although not always the best method, of correcting deep overbites. Extrusion of posteriors can be done by
myofunctional appliances, removable appliances and fixed appliance therapy. Extrusion of posterior teeth in
growing patients is stable, but in adults it may result in relapse.
Clinical case 1
Patient name A.J. had a chief complaint of mal-alignment of teeth. On examination he had an Angle Class 1 molar
relationship, severe crowding in the upper and lower arches and an impinging deep bite. The prescribed
treatment plan:
o Extraction of all the first premolars to relieve the crowding.
o Fixed bite plane to allow extrusion of molars for correction of deep bite.
o Prolonged retention with wrap around retainers with inclined plane in the upper arch for corrected deep bite
retention.

Figure 1- Pre-treatment

Figure 2- Fixed bite plane

Figure 3- 0cclusal view

Figure 4- After fixed bite plane removal

Figure 5- Post-treatment
Clinical case 2
Patient name R.S. had a chief complaint of irregular teeth. On examination she had an Angle Class II, Division 2
malocclusion with impinging deep bite. The prescribed treatment plan:
o Non-Extraction due to a pleasing profile.
o Fixed bite plane to allow extrusion of molars for correction of a deep bite.
o Prolonged retention including a wrap around retainer with inclined bite plane in the upper arch for corrected
deep bite retention.

Figure 6- Pre-treatment

Figure 7- With fixed bite plane

Figure 8- Occlusal view

Figure 9- After fixed bite plane removal

Figure 10- Post-treatment
Conclusion
The correction of a deep bite is one of the primary objectives of orthodontic treatment. A deep bite has been
considered one of the most common malocclusions and the most difficult to successfully treat. Therefore, the
optimal treatment of deep bites requires a proper diagnosis, a careful treatment plan and an efficient appliance
design. Because vertical growth continues into the late teens, a maxillary removable retainer with a bite plane is
often is needed for several years after fixed appliance orthodontics is completed. Bite depth can be maintained by
wearing the retainer only at night, after stability in other regards has been achieved.
Bibliography
1. Graber T.M. Orthodontics: Principles and Practice. 3
rd
Ed., W.B. Saunders, Philadelphia.
2.Proffit W.R., Field H.W., Ackerman J. L., Bailey L.T., Tulloch J.F.C. Contemporary Orthodontics 3
rd
, C.V.
Mosby Co; 2000.
3. Geiger A, Hirshfeld L. Minor tooth movements in general practice 3
rd
Ed. Mosby Co.
4. Nanda R. Correction of deep overbite in adults. DCNA1997; 41: 67-87.