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Can I get orthodontic treatment without extracting teeth for an overbite and crowding? <Non-extraction orthodontic case>
Hello, I'm Dr. Sohn Su-min, an orthodontic specialist at Guardians Dental Myeongdong who has been practicing at one place for 20 years. Can crowding and a deep overbite be treated together? When people think of orthodontic treatment, they often think of protruding front teeth or an overbite...
Hello.
I'm Dr. Son Soo-min, an orthodontic specialist who has been practicing at Guardians Dental Myeongdong for 20 years.
Can I get orthodontic treatment for my teeth that are tilted and deeply overlapped?
When people think of orthodontic treatment, they often think of protruding front teeth or overbites.
But a deep bite, where the front teeth are overly inclined inward, is also a type of malocclusion that requires orthodontic treatment.
Deep bites may seem like a minor problem because they are not visible from the outside.
However, when a deep bite and spacing issues occur together, simply straightening the teeth is not enough.
The angle of the front teeth must be restored, the deep bite must be improved, and the position where the upper and lower teeth functionally interlock must be designed together.
Today, we will introduce a case where we improved a deep bite, overbite, and spacing issues without extraction.
What is an overbite?
An overbite is a condition where the front teeth are tilted inward, toward the tongue, rather than outward, toward the lips.
Unlike simple tooth misalignment,
the angle between the tooth root and head is often the problem.
An overbite is an Angle's Class II malocclusion where the upper teeth are positioned more forward than the lower teeth
and is frequently observed in Class II Division 2.
This type may exhibit the following characteristics.
Not all overbites are Class II Division 2 malocclusions.
Therefore, rather than judging by the appearance of the teeth, it's better to confirm through oral photographs, tooth models, or oral scans
and X-rays to check the angle of the front teeth and the relationship between the jaw and molars.
The reason why orthodontic treatment was needed in this case
This patient had a deep overbite with the upper and lower front teeth, and the front teeth were inclined inward, which is known as an overbite.
The space for the teeth to be aligned was also insufficient, resulting in the front teeth being overlapping and crooked.
Photos of the patient at the time of visit
In such cases, simply straightening the visible teeth may not fully resolve the angle of the front teeth and the deep bite, or may even increase the gap between the upper and lower front teeth.
During the diagnosis process, the following points were focused on:
- The degree to which the upper and lower front teeth were inclined inward
- The depth to which the front teeth were vertically overlapping
- The amount of space needed for tooth alignment
- The anteroposterior relationship between the upper and lower molars
- The expected change in lip and facial profile when adjusting the angle of the front teeth
Analysis results show that the core of this treatment was not simply aligning crooked teeth, but securing necessary space without extraction and resolving the deep bite that was holding the front teeth in place, thereby restoring a normal angle and relationship between the upper and lower teeth.
Why is the order of treatment important for a deep bite?
When a deep bite and crowding occur together, the front teeth cannot be pulled back immediately.
This is because moving the already inwardly tilted teeth directly backward can worsen the deep bite and cause the front teeth to bite even more deeply.
Therefore, a step-by-step approach is generally necessary.
Guardians Dental Myeongdong, treatment process for deep bite and crowding
- Securing space and aligning the teeth, first, we created space to arrange the overlapping and crooked teeth, while organizing the teeth.
Lack of space does not always necessitate extraction.
We need to consider whether there is enough space within the dental arch and whether the gums and bones can accommodate tooth movement,
and how the balance of the lips and face will change when the front teeth are straightened.
In this case, we planned the treatment without extraction, considering these factors.
We finely adjusted the shape of the teeth and the position of each tooth within the limited space to create space for the overlapping teeth to be arranged.
2nd Step. Tilted Inward
After restoring the angle of the front teeth, we stood up the front teeth that were tilted inward to a position close to the normal angle.
Patients may feel like the front teeth are temporarily moving forward during this stage.
However, this process is difficult to skip in orthodontic treatment.
Because we need to first straighten the front teeth that are tilted backward, allowing the relationship between the upper and lower front teeth that were deeply embedded to loosen, creating a movement path to properly align the front teeth later.
When the front teeth recover their normal angle, overbite can gradually be alleviated, but the horizontal gap between the upper and lower front teeth may temporarily become wider.
This is a necessary process for the next stage.
3 steps. Overbite
After securing the space and angle for the front teeth to move, we adjusted the deep bite.
At this time, it's not just a matter of simply opening the front teeth up and down,
but the vertical position should be adjusted considering the amount of front teeth visible when smiling, gum exposure, and molar occlusion.
If necessary, treatments such as impaction or adjusting the height of the molars to move the front teeth in the direction of the gum bone can be included in the treatment plan.
If the overbite is not sufficiently improved and the front teeth are moved back, the upper and lower teeth may catch again or the overbite may recur.
So, the process of loosening the occlusion is more important than moving the front teeth back.
4. Adjustment of the front teeth's position and
After improving the angle and deep bite of the front teeth, we made detailed adjustments to reduce the gap between the upper and lower front teeth and ensure that the molars fit together stably.
In this stage, we didn't just look at the angle of the front teeth, but also checked if the lips can be closed comfortably,
if the profile is excessively concave or protruding, and if the force is evenly distributed to the left and right teeth when chewing.
Since the process of adjusting the front teeth to the appropriate position after initially setting them up is necessary, the treatment steps for Class II Division 2 malocclusion with overbite can be more complex than general orthodontic treatment.
The appearance after treating the overbite and Class II Division 2 malocclusion
After treatment, the angle of the front teeth that were leaning inward was improved, and the deep overlap of the teeth was also alleviated.
The teeth that were overlapping and twisted due to lack of space without extraction were rearranged.
The occlusion was adjusted so that the upper and lower front teeth and molars could fit together stably.
When viewed from the chewing surface, the teeth that were overlapping or angled on one side were transformed into a more balanced dental arch shape.
In conclusion
Just because this case was treated without extraction, it doesn't mean that all overbites and overcrowding can be treated without extraction.
If the space deficiency is large or the range of gums and bones that teeth can move into is limited, extraction may be more suitable.
Whether to extract or not should be determined after analyzing the angle of the front teeth, the skeletal and gum condition, and the balance of the lips and face.
At Guardians Dental Myeongdong, we don't just align the teeth, but also examine the angle of the front teeth, the cause of overbite, the relationship between the molars, the range of gums and bones that teeth can move into, and the facial balance to plan the treatment sequence.
If you're looking for orthodontic treatment, we recommend that you receive a thorough explanation from an orthodontic specialist about the treatment direction and sequence of recovering the angle of the front teeth and adjusting the deep bite and space deficiency.
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NAutomatically translated from the Korean post on our Naver blog. Read the original ↗