Deep Bite Malocclusion

Conventional orthodontic correction of Class II deep-bite deformity with a decreased lower anterior facial height tendency can be mechanically difficult, inefficient, and, in many instances, impossible. Orthodontic treatment alone of either adults or adolescents with such deformities frequently can neither increase lower anterior facial height sufficiently to achieve ideal facial proportions nor achieve long-term occlusal stability. Despite the need for surgical intervention to achieve satisfactory occlusal and esthetic results, many patients with such deformities are still being treated in clinical practice by traditional orthodontic procedures, with less than ideal esthetic and/or occlusal results. The challenge to achieve efficient and stable treatment of this deformity has been met by the use of various surgical techniques in combination with orthodontic treatment. This combined surgical-orthodontic approach can provide increased treatment efficiency, long-term stability, and optimal esthetic results. The proper sequencing and correct selection of orthodontic mechanotherapy are essential to ensure the desired results.

The purpose of this course is to detail basic problems involved in diagnosis and treatment planning for the combined surgical-orthodontic approach to patients exhibiting Class II deep bite and decreased lower facial height. Orthodontic and surgical treatment objectives are explained, and representative case reports are presented and discussed to illustrate this method of treatment. Extraction patterns, control of the transverse dimension, arch wire selection, auxiliary wires, elastics, and extraoral appliance use are described.