Deep bite /certified fixed orthodontic courses by Indian dental academy


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Deep bite /certified fixed orthodontic courses by Indian dental academy

  1. 1. THE DEEP BITE- AN ORTHODONTIC ENIGMA INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. THE DEEP BITE- AN ORTHODONTIC ENIGMA Bite opening a challenge Careful diagnosis and planning Biomechanical considerations Increasing emphasis on adult orthodontics Continuous arch mechanics may be frustrating! Requires a careful strategy
  3. 3. THE DEEP BITE- AN ORTHODONTIC ENIGMA In growing patients – Not advisable to intrude lower incisors Move posterior teeth to the level of incisors Incisor intrusion will affect vertical molar position affect facial aesthetics Depending on the severity upright molar/premolar segments or premolars
  4. 4. THE DEEP BITE- AN ORTHODONTIC ENIGMA In Adults Molar extrusion changes LAFH Not an advisable clinical procedure !! Incisor intrusion – a carefully planned solution An appropriate interincisal angle to prevent relapse
  5. 5. GENERAL PRINCIPLES Dissociate forces from moments, single point contact. Selection of point of force application and center of resistance of teeth to be intruded Control of posterior segment and reactive units Check anterior tooth geometry Extrude molars only in specific situations
  6. 6. Reverse curve of spee Ant teeth have nowhere to go except crown labial ,root lingual Round trip !!
  7. 7. Curve of Spee !! Only moments no net intrusive force
  8. 8. 2 couple system /indeterminate/minimal Intrusive force
  9. 9. Can you open a bite with a utility arch ?
  10. 10. One couple system,Off center V bend Extrusion in the shorter arm , Dissociation of moment and force
  11. 11. Single couple /determinate force system Precise application of force through center of resistance
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  13. 13. Precise force of 60 gms One point contact essential Precision essential to contain negative effects
  14. 14. For 2 central incisors-Cres on line parallel to mid sag plane pt on distal half of cuspid For 4 incisors – Cres projected line perpendicular to occlusal plane between canines and 1st bicuspids For 6 anteriors- Cres perpendicular to occlusal plane distal to 1st bicuspid
  15. 15. THREE PIECE INTRUSION ARCH 017x025 anterior segment in ss extension distal to lateral incisors tip back springs or cantilevers in 017 x025 tma calibrated for precise force
  16. 16. BIOMECHANICS-A REVIEW OF CONCEPTS Couple- pair of equal and opposite forces that produce a tendency for rotation called a moment
  17. 17. BIOMECHANICS-A REVIEW OF CONCEPTS Tooth movement is a net resultant of the equilibrium forces. The equilibrium is cognitive,not obvious and a source of surprise Tooth movement!!
  18. 18. LEVELING THE CURVE OF SPEE •Good growth increment – Buccal Segment Eruption •No Growth - incisor intrusion •3 Piece Intrusion Arch •Continuous Intrusion arches
  19. 19. Orthodontic force is 3-D
  20. 20. INCISOR INTRUSION Precision in direction and magnitude
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  22. 22. Case 8 Continuous Intrusion arch and R loop for rotation correction
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  24. 24. Case 5
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  26. 26. Three piece intrusion arch
  28. 28. Simply Lasso the cantilever!! Individual canine intrusion by cantilever
  29. 29. Pre-treatment Post-intrusion
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  50. 50. Thank you For more details please visit