Deep bite and features of treatment
09 September 2019
This article is available for reading in Russian and Ukrainian.
Braces are the most common orthodontic method for correction of occlusion and other teeth alignment disorders. Yet, they are not suitable for everyone and cause certain inconvenience to patients. This prompted the development of new orthodontic technologies. The use of caps (aligners) became an alternative to fixed braces.
Caps are a removable structure used to move teeth gradually and consistently for their alignment. Their main purpose is to shape a bite that is as close to the physiological one as possible. This is important, since any disorder associated with the position of the upper and lower dentitions relative to each other can cause increased abrasion, reduce their useful life, lead to undesirable changes in the shape of the face, headaches, and other pathological phenomena.
Caps are custom-made from a special transparent material on the basis of casts, moulds, or scans of the patient’s teeth. They are very thin, fit the dentitions snugly, bring less discomfort than braces, are easy to wear and take care of.
Alignment caps are usually recommended for adolescents above 14 years of age, but sometimes such treatment can be prescribed earlier — at 12 years of age. They should be worn for 20–22 hours a day; changes can be visible in 1–2 months.
Indications for Caps Use:
- Tremae (lack of contact between the lateral surfaces of the teeth) and diastemae (a gap of more than 1.5 mm between the anterior teeth). Patients may be not bothered by such defects, so they do not always seek help. However, these defects contribute to teeth loosening, uneven load, increased risk of caries, gum disease and further malocclusion, therefore they require correction. An HP makes the decision on the need for correction.
- Various twists or turns of the anterior teeth. Most often, these are caused by the lack of space for proper positioning of the teeth. Mouth guards ensure that the teeth are relocated to the correct position.
- Moderate intrusion of the anterior teeth. This concerns tooth immersion into the socket, which is also called a hammered dislocation. The condition can be caused by a fall or a blow into the incisal part of the tooth.
- Minor cross-bite. Pathology can be associated with both congenital and acquired causes, including caries, severe periodontitis, disordered teeth eruption. In this case, the lower and upper dentitions intersect. The manifestations include asymmetry of the face, constant biting of the mucosa, teeth abrasion.
- Further treatment with braces. Manufacturers are constantly improving aligner systems, but severe malocclusion, tooth twists, movement or intrusion by more than 2 mm require more complex long-term treatment. Usually it begins with brace installation. In such cases caps are only used at the final stages.
There are certain contraindications for the use of caps. These include: severe diseases of the internal organs and nervous system, mental disorders, the acute stage of a periodontal disease and other diseases of the oral cavity, jaw maldevelopment, and non-erupted teeth.
Aligners are used in the cases when braces are contraindicated, e. g., if a patient needs to move just 1 or 2 teeth or in excessive tooth mobility, when braces deliver too much pressure.
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