Creating the biteplate effect

There are four methods of creating the bite-plate effect:

1. Appliances can be placed on the upper arch only, which allows for proclination of (he upper incisors (f ig. 6.1 OA). This frees (he lower incisors for placement of brackets. This technique is helpful in high-angle cases, because posterior extrusion is minimized.

2. Acrylic removable anterior bite plates can be placed

(Fig. 6.1013). This is particularly helpful in low-angle deep-bite cases, because it encourages distal tipping, eruption, and extrusion of molars. The disadvantage of these removable appliances is that they are not always worn by the patient. Also, tooth movements lead to improper fit of these appliances after a relatively short period of time.

3. An adequate substitute for a removable bite plate in low-angle deep-bite cases is the placement of direct bonding material on the palatal surface of the upper incisors (Fig. 6.11). Colored adhesives such as Bandlock™ from Reliance or Transbond Plus™ from 3M Unitek are useful and can be easily removed from the tooth surfaces after bite opening.

4. In average- to high-angle cases, the placement of similar colored adhesives on the occlusal surface of the first molars is helpful in bite opening (Fig. 6.12). This adhesive can be progressively removed as (he bi(e opens. When first molars have restorations, i( may be difficult to bond to the occlusal surface of these teeth. Therefore, the second premolars or second molars can be used in such cases.

Fig. 6.10A Appliances may be placed on the upper arch only.

Palatal Bite Plate

Fig. 6.10B Acrylic removable bite plate.

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Fig. 6.10B Acrylic removable bite plate.

Fig. 6.12 Blue colored direct bonding material on the occlusal surfaces of lower first molars.

Fig. 6.11 Direct bonding material on the palatal aspect of upper incisors.

Fig. 6.12 Blue colored direct bonding material on the occlusal surfaces of lower first molars.

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