12 Increased overbite
Harry, aged 10 years and 6 months, presents with crowded upper teeth and a deep traumatic overbite (Fig. 12.1). What has caused these problems and how may they be treated?
Harry’s father has the same arrangement of the upper anterior teeth as his son. He had four teeth removed and treatment with fixed appliances as a teenager. However, the treatment result relapsed and the upper front teeth have largely returned to their original position. Harry’s mother is keen that this does not happen to her son.
The appearance of the mouth is shown in Figures 12.1 and 12.3. What do you see?
|Skeletal: anteroposterior and vertical||A Class II skeletal pattern in combination with a reduced lower facial height|
|Growth pattern||An anterior mandibular growth rotation tends to increase overbite|
|Soft tissues||Effects are via the skeletal pattern – reduced lower facial height leads to a high lower lip line that will retrocline the upper incisors, leading to overbite increase|
|A hyperactive high lower lip in association with a reduced lower facial height leads to bimaxillary retroclination|
|Dental factors||Absence of a well-defined cingulum stop on the upper incisors leads to continued eruption of the lower incisors, increasing overbite|