It is beneficial to introduce some overcorrection in deep-bite and open-bite cases. This process begins with initial bracket placement. Brackets on the anterior teeth can be placed 0.5 mm more gingival in open-bite cases and 0.5 mm more incisal in deep-bite cases (p. 65). This greatly assists in the overcorrection process.
In deep-bite cases, leveling of the curve of Spee with flat steel rectangular archwires normally results in effective bite opening, provided the second molars are included. If bite opening is not achieved using flat rectangular steel wires, then bite-opening curves can be placed. This can be done as late as the finishing stage of treatment, but it is normally completed earlier. Toward the end of treatment in deep-bite cases, patients may have only 1 -2 mm of overbite. I Iowever, they will generally settle into a position with approximately 3-4 mm of overbite. Bite-plate retainers are most beneficial in these cases to prevent subsequent overclosure of the bite.
Open-bite cases present a great challenge to the orthodontist. It is important to evaluate tongue position and tongue habits in the finishing stages of treatment. I Iopefully, this problem was observed prior to this stage, and myofunctional therapy initiated if the habit was not corrected. These cases will often benefit from the use of positioners to help bite closure. If a conventional upper retainer is to be used, a small hole can be placed in the palatal surface of the acrylic, for tongue positioning. In this way, some patients learn to modify their tongue position or activity, by holding the tip of the tongue in the roof of the palate during swallowing and other activities. However, in some cases, a tongue will reassert itself, despite the best efforts of the patient and the orthodontist. The patient should be informed of this possibility before treatment.
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