INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
OPEN BITE
Malocclusions can occur in three planes i,e.
sagittal, transverse and in the vertical plane.
Open bite is a malo...
Classification
OPEN BITE

POSTERIOR

ANTERIO
R
SKELETA
L

DENTAL

SKELETAL

www.indiandentalacademy.com

DENTAL
Anterior open bite –
Is a condition where there is no
vertical overlap between the upper and
lower incisors.

Posterior op...
Etiologic considerations

The etiology is multifactorial.
No single factor can account for most open bites.
Can occur due ...
Some of the etiologic factors responsible for
anterior open bite :
1. Prolonged Thumb-sucking.
2. Tongue thrusting.
3. Nas...
Posterior open bites are very rare.
The etiologic factors responsible for posterior

open bite :
1. Mechanical interferenc...




In cases of open bites due to thumb or finger sucking
habit , the open bite is usually assymetrically
shaped.
In cas...




An open bite can be encountered in all
distinguishable types of jaw relations and occlusal
conditions. It is frequen...
Features of skeletal anterior open bite :
• Increased lower anterior facial height.
• Decreased upper anterior facial heig...
• The patient may have a short
upper lip with excessive maxillary
incisor exposure.
• The patient often has a long and
nar...
Features of dental anterior open bite :
• Proclined upper anterior teeth.
• Upper and lower anteriors fail to
fail to over...
Esthetic Considerations




The dentoalveolar open-bite is esthetically
unattractive, particularly during speech when th...
Functional considerations








Tongue posture and function should be primary
consideration.
Differentiation between...


According to Bahr and Holt, four varieties of tongue
thrust activity may be differentiated:
1) Tongue thrust without de...
Clinical Considerations
Depending on the severity of the malocclusion, various
forms of anterior open bites may be observe...
Cephalometric Criteria
A proper cephalometric analysis enables a classification
of open-bite malocclusions.
 Extent of de...


Skeletal open bite shows:
a) Excessive anterior face height.(Lower third)
b) Posterior face height is short.(Ramus heig...
Depending on the inclination of the maxillary base, or
Palatal plane, the following variations may be observed:
 A vertic...
Therapeutic Considerations








Therapy depends on the localization and the etiology
of the malocclusion.
Habit con...




In addition, a combined skeletodental type exist that
requires a combined therapeutic approach.
Proper time to insti...
Treatment
Anterior open bite
• Removal of cause

Posterior open bite
• Removal of cause

Removable or fixed type

Lateral ...
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Open bite 1 /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Transcript of "Open bite 1 /certified fixed orthodontic courses by Indian dental academy "

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. OPEN BITE Malocclusions can occur in three planes i,e. sagittal, transverse and in the vertical plane. Open bite is a malocclusion in the vertical plane, characterized by lack of vertical overlap between the maxillary and mandibular dentition. It may be an anterior or a posterior open bite. www.indiandentalacademy.com
  3. 3. Classification OPEN BITE POSTERIOR ANTERIO R SKELETA L DENTAL SKELETAL www.indiandentalacademy.com DENTAL
  4. 4. Anterior open bite – Is a condition where there is no vertical overlap between the upper and lower incisors. Posterior open bite – Is a condition characterized by lack of contact Between the posteriors when the teeth are in centric occlusion. www.indiandentalacademy.com
  5. 5. Etiologic considerations The etiology is multifactorial. No single factor can account for most open bites. Can occur due to a variety of hereditary and non-hereditary factors. Epigenetic and environmental factors both are of concern. www.indiandentalacademy.com
  6. 6. Some of the etiologic factors responsible for anterior open bite : 1. Prolonged Thumb-sucking. 2. Tongue thrusting. 3. Nasopharyngeal airway obstruction and associated mouth breathing. 4. Inherited factors such as increased tongue size, and abnormal skeletal growth pattern of the maxilla and mandible. www.indiandentalacademy.com
  7. 7. Posterior open bites are very rare. The etiologic factors responsible for posterior open bite : 1. Mechanical interferences with the tooth eruption, either before or after the tooth emerges from the alveolar bone. 2. Failure of the eruptive mechanism of the tooth so that the expected amount of eruption does not occur. www.indiandentalacademy.com
  8. 8.   In cases of open bites due to thumb or finger sucking habit , the open bite is usually assymetrically shaped. In cases of open bites caused by the positioning of the tongue between the incisal edges of the mandibular incisors and the lingual surfaces of the maxillary incisors symmetrical. www.indiandentalacademy.com
  9. 9.   An open bite can be encountered in all distinguishable types of jaw relations and occlusal conditions. It is frequently associated with a class II/1 malocclusion. The size of the open bite may vary considerably and may range from a few millimeters to more than one centimeter. www.indiandentalacademy.com
  10. 10. Features of skeletal anterior open bite : • Increased lower anterior facial height. • Decreased upper anterior facial height. • Increased anterior and decreased posterior facial height. • A steep mandibular plane angle. • Small mandibular body and ramus. www.indiandentalacademy.com
  11. 11. • The patient may have a short upper lip with excessive maxillary incisor exposure. • The patient often has a long and narrow face. • Divergent cephalometric planes. • Steep anterior cranial base. • Downward and forward rotation of mandible. www.indiandentalacademy.com
  12. 12. Features of dental anterior open bite : • Proclined upper anterior teeth. • Upper and lower anteriors fail to fail to overlap resulting in a space. • Patient may have a narrow maxillary arch due to lowered tongue posture due to a habit. www.indiandentalacademy.com
  13. 13. Esthetic Considerations   The dentoalveolar open-bite is esthetically unattractive, particularly during speech when the tongue is pressed between the teeth and the lips. In evaluating the esthetics following relationships are of special interest : a) Balance between nose, lips, and chin profile. b) Nasolabial angle. c) Configuration of the lips. d) Length of the lower third of the face. www.indiandentalacademy.com
  14. 14. Functional considerations     Tongue posture and function should be primary consideration. Differentiation between primary causal and secondary adaptive or compensatory dysfunction is essential. Functional analysis also must bassess the magnitude of force ( i,e simple pressing versus strong protractive action). Cephalometric analysis can localise the nature of open bite – Skeletal/Dental. www.indiandentalacademy.com
  15. 15.  According to Bahr and Holt, four varieties of tongue thrust activity may be differentiated: 1) Tongue thrust without deformation. 2) Tongue thrust causing anterior deformation – A Simple Open Bite (Termed by MOYERS 1964) 3) Tongue thrust causing buccal segment deformation.(Posterior open bite often seen) 4) Combined tongue thrust, causing both anterior and posterior open bite – A Complex Open Bite (Termed by MOYERS ) www.indiandentalacademy.com
  16. 16. Clinical Considerations Depending on the severity of the malocclusion, various forms of anterior open bites may be observed:  Pseudo-open bite.  Simple open bite.  Complex open bite.  Compound or infantile open bite.  Iatrogenic open bite. www.indiandentalacademy.com
  17. 17. Cephalometric Criteria A proper cephalometric analysis enables a classification of open-bite malocclusions.  Extent of dentoalveolar open bite depends upon a) The extent of the eruption of the teeth. b) The Growth pattern. www.indiandentalacademy.com
  18. 18.  Skeletal open bite shows: a) Excessive anterior face height.(Lower third) b) Posterior face height is short.(Ramus height) c) Mandibular base is usually narrow. d) Symphysis is narrow and long and the ramus is short. e) Gonial angle particularly the lower section will be large. www.indiandentalacademy.com
  19. 19. Depending on the inclination of the maxillary base, or Palatal plane, the following variations may be observed:  A vertical growth pattern with upward tipping of the forward end of the maxillary base.  A vertical growth pattern with downward tipping of the anterior end of the maxillary base.  A horizontal growth direction with an open bite caused by upward and forward tipping of the maxillary base. www.indiandentalacademy.com
  20. 20. Therapeutic Considerations     Therapy depends on the localization and the etiology of the malocclusion. Habit control and the elimination of the abnormal perioral muscle function are therapeutic approaches in the treatment of dentoalveolar open-bite problems. In skeletal open-bite problems a redirection of growth is possible during the active growth period. Later, only compensatory therapy with extraction and tooth movement or orthognathic surgery is possible. www.indiandentalacademy.com
  21. 21.   In addition, a combined skeletodental type exist that requires a combined therapeutic approach. Proper time to institute the treatment depends on the etiology of the malocclusion. www.indiandentalacademy.com
  22. 22. Treatment Anterior open bite • Removal of cause Posterior open bite • Removal of cause Removable or fixed type Lateral tongue spikes for habit breaking appliance. lateral tongue thrust. • Myofunctional appliances Skeletal anterior open bite – F.R.IV or a modified activator • Fixed Orthodontic therapy • Surgical correction • If due to infra occlusion of ankylosed teeth, it is best treated by crowns. www.indiandentalacademy.com
  23. 23. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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