Evaluation of long-term stability of curve of Spee levelled with continuous archwires in two different retention protocol

Objectives: The objectives of the study were to assess the long-term stability of the curve of Spee leveled with continuous archwire in subjects with two different retention protocols. Materials and Methods: The study sample consisted of 20 patients (mean age 18 ± 2 years) presenting with curve of Spee depth of =/> 3 mm. For each subject, lateral cephalograms and dental casts were available before treatment (T1), at the end of orthodontic therapy (T2), and 1 year after the end of treatment (T3). All subjects were divided into two groups according to their retention protocol – fixed retainer group (Group-1) and Essix retainer group (Group-2). Cephalometric parameters were used to evaluate the dental movements after treatment. Curve of Spee depth was measured on standardized digital images of casts. Results: In multicomparison table, it shows that there was a statistically significant difference (P = 0.032) between Spee-T2 and Spee-T3 and there was no statistical difference (P = 0.159) between L1MP-T2 and L1MP-T3 in fixed retainer group. In Essix retainer group, no changes were observed from L1MP-T2 to L1MP-T3 and there was a non-significant difference found between Spee-T2 and Spee-T3. Conclusion: In Group-1 (fixed retainer), there is some amount of relapse or extrusion of lower incisor. In Group-2 (Essix retainer), there was not any change in the position of the lower incisor, which suggests that occlusal coverage of the Essix retainer does not allow any extrusion and retains the curve of Spee.

Orthodontic, Maxillofacial Surgery, and Prosthodontic Rehabilitation Supported by Miniscrew in a Patient with Cleft Lip and Palate

Aim. This paper is aimed at reporting the clinical case of a patient with cleft lip and palate treated with a multidisciplinary approach. Case Report. An 11-year-old patient presented cleft lip and palate, with persistent oronasal communication, tooth displacement, and upper and lower crowding with a deep curve of Spee. He was treated with metal bracket orthodontic therapy, graft surgery, and prosthetic rehabilitation supported by miniscrews. Conclusions. Cleft lip and/or palate patients require adequate management of the case to resolve the anomalies connected to their condition and to improve their quality of life.

A comparative study between the effect of reverse curve of Spee archwires and anterior bite turbos in the treatment of deep overbite cases: A randomized clinical trial

ABSTRACT Objectives To compare deep overbite treatment using 0.016 × 0.022 nickel-titanium lower reverse curve of Spee archwire (LRCA) or metal anterior bite turbos (ABTs). Materials and Methods 48 patients with deep overbite malocclusion were randomly allocated into two groups. Group I (age = 18.4 ± 2.8 years, overbite = 5.8 ± 0.6 mm) was treated with LRCA, while Group II (age = 18.2 ± 3.1 years, overbite = 5.2 ± 0.4 mm) was treated with ABTs bonded to the palatal surface of the upper central incisors. Two cephalograms were taken for each patient, at post-alignment stage (T1) and post-leveling stage (T2). The primary outcomes were the anteroposterior and vertical changes of the lower teeth. The secondary outcomes were the effect on upper incisor inclination and the vertical linear changes of upper teeth, to assess the sagittal and vertical skeletal changes, and to compare the duration of overbite correction. Results 42 of the 48 patients recruited completed the study (21 in each group). At T2, the lower incisors proclined more in Group I (P ≤ .001). Both lower second molars (P ≤ .001) and lower first molars (P = .001) tipped more distally, while the lower first premolar tipped more mesially, in Group I (P < .05). All cusps of both lower molars showed more extrusion in Group II (P < .05) except for the mesial cusp of lower second molars (P = .095). The duration of overbite correction was shorter using the ABTs by 1.7 months (4.85 ± 1.56 and 3.15 ± 0.93 months for Group I and Group II, respectively). Conclusions LRCA causes lower incisor proclination with distal tipping of lower molars, while ABTs result in lower posterior tooth extrusion.

Precision bite ramps and aligners: An elective choice for deep bite treatment

Objective: To review a series of clinical studies demonstrating the clinical efficiency of aligners with bite ramps in the treatment of severe deep bite. Materials and Methods: In order to predictably manage the correction of deep bite with aligners, precision bite ramps on maxillary incisors have been used while posterior extrusion and anterior intrusion in the lower jaw with lateral attachments and proper levelling of the curve of Spee have been planned. Transverse correction and controlled upper and lower incisors proclination completed the treatment plan. Results: Full deep bite correction with normal overbite was obtained in nine months of treatment by a combination of anterior intrusion and posterior torque correction, distal tipping and relative extrusion. Conclusion: The use of bite ramps represents a valid option for the successful treatment of deep bite with aligners creating proper space for lateral sector extrusion and supporting lower anterior intrusion and controlled proclination.

Treatment of deep overbite in mixed dentition: a clinical case report

Relevance. Deep overbite is one of the most frequent malocclusions in children and teenagers of different ages. Distal occlusion with a deep overbite is the most common (59.6-67.6% according to the literature) in early mixed dentition. Most Russian and international authors state in their research that the severity of malocclusion increases with age. The treatment of the pathology in children is relevant due to deterioration of the deep overbite with age, worsening of functional disorders.Materials and methods. The study analyses the treatment results of a child with a deep bite using the authors’ technique.Results. The study demonstrated the advantages of the authors’ technique. The treatment allowed achieving normal dentoalveolar heights in the posterior mandible on molar and premolar eruption, establishing the correct relationship between the upper and lower dental arches that promoted harmonious development of the child’s maxillofacial area. The treatment regulated the length and width of the upper dental arch and corrected its form. The active intrusion of the lower incisors and extrusion of the lower posterior teeth were observed during the treatment. The curve of Spee was restored, and an increased overlap reduced. Occlusal contacts of posterior teeth improved, and deep overbite decreased. The technique is easy to use and allows curing 9-12-year-old children in a short period (7-10 months).Conclusions. The suggested technique treats deep overbite as well as creates conditions for the further harmonious development of the maxillofacial area. Thus, it can be recommended for the treatment in early mixed dentition.

Evaluation and Comparison of Skeletal and Dental Components of Deep Overbite Malocclusion with Normal Occlusion

BACKGROUND A deep overbite may be due to an underlying skeletal or dentoalveolar component that may influence the treatment plan. The purpose of this study was to evaluate and compare the different components of deep bite malocclusion and normal occlusion. METHODS This was a case control study. Lateral cephalograms and study casts of normal (N = 50) and deep overbite (N = 50) subjects were used to evaluate skeletal and dentoalveolar components. Data was analysed statistically by independent t - test. RESULTS The significant skeletal contributing factors were gonial angles, mandibular plane, maxillary plane angle & ramus / Frankfort horizontal. An increased curve of Spee and decreased mandibular first molar height were predominant dental variables in the deep overbite group. The inclination of the upper incisors & lower incisors height did not show a statistically significant difference between the two groups. CONCLUSIONS The counterclockwise rotation of the mandible and the increased curve of Spee were the dominant features of deep bite malocclusion. This analysis of deep overbite components could help clinicians design individualised mechanotherapy based on the underlying cause rather than being prejudiced toward conventional mechanics when correcting with a deep overbite malocclusion. KEY WORDS Skeletal and Dental Components, Deep Overbite, Ramus / Frankfort Horizontal