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بسم الله الرحمن الرحيم
VERTICAL MALOCCLUSION GaidaaBushra. Supervised By Dr. Altohami
DEF. Malocclusion Variation from ideal occlusion which has dental health and/or psychological implications for the individual.
Malocclusion can occur in three plans of spaces i.e ,[object Object]
Transverse
vertical,[object Object]
OPEN BITE DEF. ,[object Object]
Characterized by lack of vertical overlap between the maxillary and mandibular dentition.,[object Object]
[object Object],[object Object],[object Object],[object Object]
Skeletal open bite
Dental open bite,[object Object]
Prolonged thumb-sucking habit. (most, posture, position, intensity, frequency, etc).
Tongue thrusting. (some cases)
Mouth breathing. (associated with nasopharyngeal airway obstruction )
Inherited factors. (large tongue size, abnormal skeletal growth, etc),[object Object]
FEARTURES! SKELETAL DENTAL Increased lower anterior facial height. Decreased upper anterior facial height. A steep mandibular plane angle. Small mandibular body and ramus. Proclined upper teeth. The upper and lower anteriors fail to overlap each other. The patient may  have a narrow maxillary arch duo to lowered tongue posture duo to a habit.
TREATMENT ,[object Object],Habits, by passive habit breaking appliance. Habit breaker appliance can be either fixed or removable. Persistence of all the causes will offer a sever limitation in the corrective procedures!!
[object Object],Functional appliance, e.g. head gear with chin cup for pt exhibiting a downward and backward rotation of the mandible with increased vertical growth (if treated during mixed dentition period).
[object Object],Mild to moderate open bite can be successfully managed using fixed appliance with box elastics. Elastic that is stretched to extend between the upper and lower anteriors.  this brings extrusion of the upper and lower anteriors.
[object Object],Skeletal open bites in adults are best treated by surgical procedure involving the maxilla and the mandible.
POSTERIOR OPEN BITE   DEF. is a condition characterized by lack of contact between the posteriors when the teeth are in centric occlusion.
[object Object]
Mechanical interference with eruption, either before or after the tooth emerges from the alveolar bone.
Failure of the eruptive mechanism of the tooth so that the expected amount of eruption does not occur.,[object Object]
NB. ,[object Object],[object Object]
After the tooth emerges from the bone, pressure from soft tissue interposed between teeth (cheek, tongue, finger) can be an obstacle to eruption.
Infraocclusion by ankylosed teeth.  ,[object Object],[object Object]
Remove the cause. Lateral tongue spikes (to avoid tongue thrust). Extrusion of the posteriors forcefully. Infraocclusion by crowns to restore normal occlusal level.
VERTICAL MALOCCLUSION
DEEP BITE DEF. ,[object Object]
One third – one half coverage is normal, greater will be increased, thus termed overbite.,[object Object]
This overlapping of the mandibular teeth occurs both the horizontal as well as vertical direction. The horizontal                   overjet The vertical                        overbite
Overbite can be : ,[object Object]
Complete overbite. ,[object Object]
Deep bite can be  broadly classified into : Skeletal dental
SKELETAL DEEP BITE Genetic origin. Caused by upward and forward rotation of the mandible, which can be worsen by a downward and forward inclination of the maxilla!!!
SKELETAL DEEP BITE Features: Pt exhibit horizontal growth pattern The anterior facial height is reduced A reduced inter-occlusal clearance (freeway space)
DENTAL DEEP BITE This kind of deep bite is characterized by the absence of any skeletal complicating features that are seen in skeletal deep bites. Dental deep bite occur duo to over-eruption of anteriors OR infra-occlusion of posterior.
Deep bite duo to over-eruption of anteriors: is usually seen in class II malocclusion. The presence of an          overjet allows the lower incisors to over-erupt, until they meet the palatal mucosa. The pt hence exhibit an excessive curve of spee.
Deep bite duo to infra-occlusion of molars : the presence of a large tongue posture or lateral tongue thrust may prevent the molars from erupting to their normal occlusal level. It can also occur due to premature loss of posterior teeth.
Lip relationship: ,[object Object],exhibit a short lip or a gummy smile should be treated by intrusion of the anteriors. ,[object Object],[object Object]
Removable                Hawley’s appliance + Adam’s clasps on the molars for retention.  Myofunctional                 activator desinged and trimmed to allow the extrusion.   Bionator can also be used.
Fixed                  to intrude the anteriors.
Fixed anterior bite plane can be use in conjunction withthe fixed appliance.

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Vertical Malocclusion

  • 2. VERTICAL MALOCCLUSION GaidaaBushra. Supervised By Dr. Altohami
  • 3. DEF. Malocclusion Variation from ideal occlusion which has dental health and/or psychological implications for the individual.
  • 4.
  • 5.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 13.
  • 14. Prolonged thumb-sucking habit. (most, posture, position, intensity, frequency, etc).
  • 16. Mouth breathing. (associated with nasopharyngeal airway obstruction )
  • 17.
  • 18.
  • 19. FEARTURES! SKELETAL DENTAL Increased lower anterior facial height. Decreased upper anterior facial height. A steep mandibular plane angle. Small mandibular body and ramus. Proclined upper teeth. The upper and lower anteriors fail to overlap each other. The patient may have a narrow maxillary arch duo to lowered tongue posture duo to a habit.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. POSTERIOR OPEN BITE DEF. is a condition characterized by lack of contact between the posteriors when the teeth are in centric occlusion.
  • 32.
  • 33. Mechanical interference with eruption, either before or after the tooth emerges from the alveolar bone.
  • 34.
  • 35.
  • 36. After the tooth emerges from the bone, pressure from soft tissue interposed between teeth (cheek, tongue, finger) can be an obstacle to eruption.
  • 37.
  • 38. Remove the cause. Lateral tongue spikes (to avoid tongue thrust). Extrusion of the posteriors forcefully. Infraocclusion by crowns to restore normal occlusal level.
  • 39.
  • 41.
  • 42.
  • 43.
  • 44. This overlapping of the mandibular teeth occurs both the horizontal as well as vertical direction. The horizontal overjet The vertical overbite
  • 45.
  • 46.
  • 47. Deep bite can be broadly classified into : Skeletal dental
  • 48. SKELETAL DEEP BITE Genetic origin. Caused by upward and forward rotation of the mandible, which can be worsen by a downward and forward inclination of the maxilla!!!
  • 49.
  • 50. SKELETAL DEEP BITE Features: Pt exhibit horizontal growth pattern The anterior facial height is reduced A reduced inter-occlusal clearance (freeway space)
  • 51.
  • 52.
  • 53.
  • 54.
  • 55. DENTAL DEEP BITE This kind of deep bite is characterized by the absence of any skeletal complicating features that are seen in skeletal deep bites. Dental deep bite occur duo to over-eruption of anteriors OR infra-occlusion of posterior.
  • 56.
  • 57.
  • 58. Deep bite duo to over-eruption of anteriors: is usually seen in class II malocclusion. The presence of an overjet allows the lower incisors to over-erupt, until they meet the palatal mucosa. The pt hence exhibit an excessive curve of spee.
  • 59. Deep bite duo to infra-occlusion of molars : the presence of a large tongue posture or lateral tongue thrust may prevent the molars from erupting to their normal occlusal level. It can also occur due to premature loss of posterior teeth.
  • 60.
  • 61.
  • 62. Removable Hawley’s appliance + Adam’s clasps on the molars for retention. Myofunctional activator desinged and trimmed to allow the extrusion. Bionator can also be used.
  • 63. Fixed to intrude the anteriors.
  • 64. Fixed anterior bite plane can be use in conjunction withthe fixed appliance.
  • 65.
  • 66.