Nita Kumari Bhateja, Mubassar Fida, Attiya Shaikh


Background: Correction of deep bite is crucial for maintenance of dental hard and soft tissue structures and for prevention of temporomandibular joint disorders. Exploration of underlying skeletal and dental factors is essential for efficient and individualized treatment planning. To date etiological factors of dental and skeletal deep bite have not been explored in Pakistani orthodontic patients. The objectives of this study were to explore frequencies of dental and skeletal etiological factors in deep bite patients and to determine correlations amongst dental and skeletal etiological factors of deep bite. Methods: The study included a total of 113 subjects (males=35; females=78) with no craniofacial syndromes or prior orthodontic treatment. Pre-treatment orthodontic records were used to evaluate various dental and skeletal parameters. Descriptive statistics of each parameter were calculated. The various study parameters were correlated using Pearson’s Correlation. Results: Deep curve of Spee was most frequently seen factor of dental deep bite (72.6%), followed by increased coronal length of upper incisors (28.3%), retroclined upper incisors (17.7%), retroclined lower incisors (8%) and increased coronal length of lower incisors (5.3%). Decreased gonial angle was most commonly found factor of skeletal deep bite (43.4%), followed by decreased mandibular plane angle (27.4%) and maxillary plane's clockwise rotation (26.5%). Frankfort mandibular plane angle and gonial angle showed a strong positive correlation (r=0.66, p=0.000). Conclusions: Reduced gonial angle is most frequently seen skeletal factor, signifying the importance of angulation and growth of ramus in development of deep bite. Deep curve of Spee is most frequently seen dental etiological component in deep bite subjects, hence signifying the importance of intruding the lower anterior teeth

Keywords: Deep bite, dental factors, skeletal factors

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Daskalogiannakis J, Ammann A. Glossary of orthodontic terms. Quintessence Books Chicago; 2000.

Strang R. An analysis of the overbite problems in Malocclusion. Angle Orthod 1934;4(1):65–84.

Bergerson EO. A longitudinal study of anterior vertical overbite from eight to twenty years of age. Angle Orthod 1988;58(3):237–56.

Parker CD, Nanda RS, Currier GF. Skeletal and dental changes associated with the treatment of deep bite malocclusion. Am J Orthod Dentofacial Orthop 1995;107(4):382–93.

Proffit WR, Fields HW, editors. Contemporary orthodontics. St Louis: C. V. Mosby; 2007;3–92.

Drury TF, Winn DM, Snowden CB, Kingman A, Kleinman DV, Lewis B. An overview of the oral health component of the 1988-1991 National Health and Nutrition Examination Survey (NHANES III-Phase 1). J Dent Res 1996;75:620–30.

Gul-e-Erum, Fida M. Pattern of malocclusion in orthodontic patients: a hospital based study. J Ayub Med Coll Abbottabad 2008;20(1):43–7.

Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod 1989;11(3):309–20.

Baydas B, Yavuz I, Atasaral N, Ceylan I, Dagsuyu I. Investigation of the changes in the positions of upper and lower incisors, overjet, overbite, and irregularity index in subjects with different depths of curve of Spee. Angle Orthod 2004;74(3):349–55.

Sangcharearn Y, HO C. Effect of incisors angulation on overjet and overbite in class II camouflage treatment. Angle Orthod 2007;77(6):1011–8.

Faerovig E, Zachrisson BU. Effects of mandibular incisor extraction on anterior occlusion in adults with class III malocclusion and reduced overbite. Am J Orthod Dentofacial Orthop 1999;115(2):113–24.

Zhylich D, Suri S. Mandibular incisor extraction: a systematic review of an uncommon extraction choice in orthodontic treatment. J Orthod 2011;38(3):185–95.

Forsberg CM, Hellsing E. The effect of a lingual arch appliance with anterior bite plane in deep overbite correction. Eur J Orthod 1984;6(2):107–15.

Mills CM, McCulloch KJ. Treatment effects of the twin block appliance: a cephalometric study. Am J Orthod Dentofacial Orthop 1998;114(1):15–24.

Bernstein RL, Preston CB, Lampasso J. Leveling the curve of Spee with a continuous archwire technique: a long term cephalometric study. Am J Orthod Dentofacial Orthop 2007;131(3):363–71.

Godt A, Kalwitzki M, Goz G. Effects of cervical headgear on overbite against the background of existing growth patterns. A retrospective analysis of study casts. Angle Orthod 2007;77(1):42–6.

Aydogdu E, Ozsoy OP. Effects of mandibular incisor intrusion obtained using a conventional utility arch vs. bone anchorage. Angle Orthod 2011;81(5):767–75.

Senisik NE, Turkkahraman H. Treatment effects of intrusion arches and mini-implant systems in deep bite patients. Am J Orthod Dentofacial Orthop 2012;141(6):723–33.

Ishihara Y, Kuroda S, Sugawara Y, Balam TA, Takano-Yamamoto T, Yamashiro T. Indirect usage of miniscrew anchorage to intrude overerupted mandibular incisors in a Class II patient with a deep overbite. Am J Orthod Dentofacial Orthop 2013;143(4 Suppl):S113–24.

Jager A, Kubein-Meesenburg D, Luhr HG. Longitudinal study of combined orthodontic and surgical treatment of class II malocclusion with deep overbite. Int J Adult Orthodon Orthognath Surg 1991;6(1):29–38.

Noroozi H. A simple method of determining the bite-opening effect of posterior extrusion. J Clin Orthod 1999;33(12):712–4.

Ng J, Major PW, Heo G, Flores-Mir C. True incisor intrusion attained during orthodontic treatment: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2005;128(2):212–9.

McDowell EH, Baker IM. The skeletodental adaptations in deep bite correction. Am J Orthod Dentofacial Orthop 1991;100(4):370–5.

Jacobson A, Jacobson R. Radiographic Cephalometry From Basic to 3-D Imaging. 2nd ed. Hanover Park, IL: Quintessence Publishing Co; 2006.

El-Dawlatly MM, Fayed MM, Mostafa YA. Deep overbite malocclusion: analysis of the underlying components. Am J Orthod Dentofacial Orthop 2012;142(4):473–80.

Ceylan I, Eroz UB. The effects of overbite on the maxillary and mandibular morphology. Angle Orthod 2001;71(2):110–5.

Marshall SD, Caspersen M, Hardinger RR, Franciscus RG, Aquilino SA, Southard TE. Development of the curve of Spee. Am J Orthod Dentofacial Orthop 2008;134(3):344–52.

Burstone CR. Deep overbite correction by intrusion. Am J Orthod 1977;72(1):1–22.

Zachrisson BU. Esthetic factors involved in anterior tooth display and the smile vertical dimension. J Clin Orthod 1998;32(7):432–45.

Tweed CH. The Frankfort-mandibular plane angle in orthodontic diagnosis, classification, treatment planning, and prognosis. Am J Orthod Oral Surg 1946;32(4):175–230.


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