Diagnosis
Dental vs. skeletal deep bites
Dental deep bites:
- Will have no abnormal extra-oral features
- Can include retroclined lower incisors with crowding. Overeruption of incisors follows to develop a deep bite malocclusion
Skeletal deep bites:
- Can be diagnosed by comparing the mandibular plane angle to the frankfurt horizontal, cranial base or to the maxillary plane
- Dentally the features are similar to a dental deep bite but can often be more severe
Aetiology of the deep bite
Dental deep bites:
- Soft tissue forces (i.e. strong lip pressure can cause retroclination of incisors and a deeper overbite)
- Crowding and displacement of incisors (i.e. lower incisor crowding can lead to retroclined incisors and a deepbite)
- Overeruption of incisors
- Lack of eruption of posterior teeth
Skeletal deep bites:
- Genetics (i.e. forward and upward mandibular growth pattern)
- Increased masticatory muscle activity
Clinical Considerations
Treat the aetiology
- Treat the aetiology to achieve better aesthetic outcomes and stability.
- A deep bite can be opened by posterior extrusion, incisor intrusion, incisor proclination or a combination of these. The choice of treatment needs to address the aetiology.
- Incorrect treatment options can lead to worsening of a Class II appearance or gummy smile.
