Comparison between effects of reverse curve of Spee nickel titanium archwire and stainless steel archwires with and without torque on the lower incisors in deep overbite treatment: a randomized control study.

OBJECTIVES: To compare the effect between three different reverse curve of Spee (RCOS) archwires: 0.016 × 0.022-inch Nickel-Titanium and 0.019 × 0.025-inch stainless steel (SS) with and without crown labial torque (CLT) on lower incisors during deep overbite treatment. MATERIALS AND METHODS: Eighty subjects with deep overbite were randomly divided into three groups: the first group (mean age: 20.5 years) received SS RCOS with CLT, the second group (mean age: 19.4 years) was treated with 0.019 × 0.025-inch SS RCOS with zero CLT, the third group (mean age: 18.2 years) was treated with rocking-chair nickel-titanium (NiTi) 0.016 × 0.022-inch with RCOS. Two lateral cephalometric images were taken for each patient, one after alignment and the second after deep bite correction. These images were superimposed using the corpus axis to study the lower incisor horizontal and vertical changes. RESULTS: The lower incisor angular change was significantly smaller in Group II (-0.3°) compared to Group I (4.8°) and Group III (6.0°, P ≤ .001). Lower incisor anterior movement was reduced in Group II compared to Group I (P = .014) and Group III (P = .008). Group III showed significantly more downward movement of the lower Incisors (P ≤ .001). The three groups showed comparable amounts of true intrusion (1 mm, P = .536). CONCLUSIONS: 0.016 × 0.022-inch NiTi and 0.019 × 0.025-inch SS with crown labial torque RCOS archwires resulted in similar proclination and forward movement of the lower incisors. Removal of anterior crown labial torque from the 0.019 × 0.025-inch SS RCOS archwire prevents lower incisor proclination and forward movement.

Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders: A case report and review of literature.

BACKGROUND: The relation between orthodontic treatment and temporomandibular disorders (TMDs) is under debate; the management of TMD during orthodontic treatment has always been a challenge. If TMD symptoms occur during orthodontic treatment, an immediate pause of orthodontic adjustments is recommended; the treatment can resume when the symptoms are managed and stabilized. CASE SUMMARY: This case report presents a patient (26-year-old, female) with angle class I, skeletal class II and TMDs. The treatment was a hybrid of clear aligners, fixed appliances and temporary anchorage devices (TADs). After 3 mo resting and treatment on her TMD, the patient's TMD symptom alleviated, but her anterior occlusion displayed deep overbite. Therefore, the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves. After the levelling, the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion. After careful examination of temporomandibular joints (TMJ) position, the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion. Eventually, the improved facial appearance and relatively stable occlusion were achieved. The 1-year follow-up records showed there was no obvious change in TMJ morphology, and her occlusion was stable. CONCLUSION: TMD screening and monitoring is of great clinical importance in the TMD susceptible patients. Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

Orthodontic correction of an adult patient with closed deep overbite using clear aligners:A case report / 实用口腔医学杂志

An adult female presented with severe closed overbite,class Ⅱ skeletal and dental malocclusion,low angle and straight face.Helped with the clear aligners,the class Ⅱ dental malocclusion was corrected by maxillary molars distalization,the occlusion of anterior teeth were opened by posterior teeth extention and anterior teeth intrusion,and finally a balanced occlusion and an ideal smile line were obtained.

Clear aligner treatment assisted by mini screw for an adult with Class II division 2 malocclusion and a right upper canine completely outside of the dental arch: A case report.

This case report describes a 19-year-old man presented with a 5.7-mm deep overbite, Class II division 2 malocclusion with the right upper maxillary canine completely buccal ectopia, deviated midline in the upper arch, severe crowding and retroclination of the maxillary and mandibular incisors. The patient was treated with clear aligners to correct the Class II relationship and the deep overbite. A series of clear aligners were used to move bilateral maxillary molars distally with unilateral mini-screw anchorage. The final results showed that clear aligners with mini-screws could effectively achieve the required upper distal molar movement thanks to a reasonable design of the stages and anchorage. The treatment was completed in 19 months and the patient was satisfied with the treatment outcome in this context of mild to moderate Class II division 2 malocclusion.

Quantifying the efficacy of overbite reduction in patients treated with clear aligners using optimized versus conventional attachments.

BACKGROUND: Deep overbite has been shown to be difficult to correct with clear aligners. Optimized deep bite attachments are reported to facilitate deep bite correction with aligners. The aim of this retrospective study was to quantify the efficacy of deep bite correction with aligners when using optimized versus conventional attachments. METHODS: This was a retrospective cohort study. The pretreatment and post-treatment intraoral scans of patients with deep overbite treated with Invisalign clear aligners were accessed. Patients were divided into two groups: group A, patients treated with conventional attachments, and group B, patients treated with optimized attachments. Pre and post-treatment overbite and the planned overbite reduction were measured and compared between groups. Descriptive statistics were computed, and statistical significance was set at P < 0.05. RESULTS: Seventy-eight patients were included. There was no statistically significant difference in overbite reduction between patients who had conventional versus optimized attachments. The amount of overbite reduction observed post-treatment was found to be no more than 33-40% of the planned amount of overbite reduction across all patients and groups. CONCLUSIONS: Deep overbite correction with aligners remains difficult regardless of the type of attachment used. Optimized attachments are no more effective than using conventional attachments in reducing deep overbite. The amount of overbite reduction expected with clear aligners is significantly lower than the planned overbite reduction. PRACTICAL IMPLICATIONS: When correcting deep bite with clear aligners, the attachment type does not improve the success rate. Clinicians should plan to overcorrect deep bite reduction to expect only 33% to 40% of their planned final overbite to be actually expressed.

Evaluation of condyle-fossa relationships in skeletal Class I malocclusion with variable degrees of deep overbite and open bite.

OBJECTIVE: To compare the temporomandibular joint (TMJ) position and shape between skeletal Class I subjects with different degrees of deep overbite or open bite and unaffected peers. METHODS: Cone beam computed tomography (CBCT) images of 90 participants, equally divided into deep bite, open bite, and control groups (DBG, OBG, and CG, respectively), were analyzed. The DBG and OBG were further subdivided into three subgroups based on the severity. Linear and angular measurements were used to determine the positional and morphological characteristics of the TMJ. RESULTS: DBG showed significantly larger superior joint space, anterior inclination of the condyle, and articular eminence inclination than CG and OBG. The severity of deep bite and open bite significantly influenced the TMJ position and morphology. CONCLUSION: In severe deep overbite and open bite cases, there were considerable alterations in TMJ components, most likely as a result of functional demands.

Three-dimensional assessment of temporomandibular joint in skeletal Class I malocclusion with variable degrees of overbite and overjet.

OBJECTIVE: To three-dimensionally evaluate the position and morphology of the TMJ in skeletal Class I with variable degrees of overbite and overjet in comparison with normal peers. METHODS: Pretreatment CBCT scans of 126 adults were retrieved. Based on the severity of overjet and overbite, the sample was divided into three main groups and six subgroups (18 patients each): the first group with a normal overbite and variable overjet degree and the second group with normal overjet and variable overbite degree. These six subgroups were compared with a third control group of normal overjet and overbite. RESULTS: There were significant differences in vertical condylar position, vertical and anteroposterior condylar inclinations, condylar height, and significant posterior condylar positioning in severe deep overbite, compared with the control group. CONCLUSION: There were significant changes in the TMJ components in severe deep overbite cases. Therefore, sever deep overbite could be considered a predisposing factor for temporomandibular disorders.

Treatment of Dental Class-II, Division 2 Malocclusion Associated with a Deep Anterior Overbite: A Case Report Orthodontic Camouflage.

AIM: This study sought to correct the assessment of orthodontic camouflage treatment to provide a harmonized soft-tissue profile, consistent occlusion, and a pleasant smile. BACKGROUND: Class-II, division 2 malocclusions can be treated through dental compensation and growth modification methods instead of surgical-orthodontic treatment, which can be determined by the growth and age of the patient. CASE DESCRIPTION: This case report was of a 14-year-old Chinese female whose chief complaint was crowding of anterior teeth and required treatment for the same. On necessary clinical and radiographical examination, diagnosis of convex facial profile with class-II, division 2 malocclusion was arrived and hence treated with orthodontic camouflage. On treatment completion of 33 months, cephalometric assessment revealed that the anterior maxillary teeth had been successfully intruded and substantially distalized, with a slight counterclockwise rotation of the mandible. The treatment results and profile changes were demonstrated with good patient cooperation. CONCLUSION: Using a utility arch with orthodontic camouflage treatment can help to reinforce molar anchoring and improve a deep bite in the maxillary dentitions. The patient was treated with the devised treatment plan and acceptable results were obtained with patient satisfaction as recorded after 1 year of follow-up. CLINICAL SIGNIFICANCE: To correct a maxillomandibular discrepancy, an orthodontist may conduct a process known as camouflage therapy without necessity of surgery. However, patient selection forms a crucial role, and hence systematic arrival of the diagnosis and treatment protocol is a pivotal factor.

A comparative study between the effect of reverse curve of Spee archwires and anterior bite turbos in the treatment of deep overbite cases.

OBJECTIVES: To compare deep overbite treatment using 0.016 × 0.022 nickel-titanium lower reverse curve of Spee archwire (LRCA) or metal anterior bite turbos (ABTs). MATERIALS AND METHODS: 48 patients with deep overbite malocclusion were randomly allocated into two groups. Group I (age = 18.4 ± 2.8 years, overbite = 5.8 ± 0.6 mm) was treated with LRCA, while Group II (age = 18.2 ± 3.1 years, overbite = 5.2 ± 0.4 mm) was treated with ABTs bonded to the palatal surface of the upper central incisors. Two cephalograms were taken for each patient, at post-alignment stage (T1) and post-leveling stage (T2). The primary outcomes were the anteroposterior and vertical changes of the lower teeth. The secondary outcomes were the effect on upper incisor inclination and the vertical linear changes of upper teeth, to assess the sagittal and vertical skeletal changes, and to compare the duration of overbite correction. RESULTS: 42 of the 48 patients recruited completed the study (21 in each group). At T2, the lower incisors proclined more in Group I (P ≤ .001). Both lower second molars (P ≤ .001) and lower first molars (P = .001) tipped more distally, while the lower first premolar tipped more mesially, in Group I (P < .05). All cusps of both lower molars showed more extrusion in Group II (P < .05) except for the mesial cusp of lower second molars (P = .095). The duration of overbite correction was shorter using the ABTs by 1.7 months (4.85 ± 1.56 and 3.15 ± 0.93 months for Group I and Group II, respectively). CONCLUSIONS: LRCA causes lower incisor proclination with distal tipping of lower molars, while ABTs result in lower posterior tooth extrusion.

The effect of orthodontic treatment on temporomandibular joint morphology in adult skeletal class II deep overbite patients.

OBJECTIVE: To explore the morphological changes of the temporomandibular joint (TMJ) in adult patients with skeletal class II deep overbite before and after orthodontic treatment, and to analyze the effect of the orthodontic treatment. METHODS: A total of 40 adult skeletal class II deep overbite patients were recruited as the study cohort. For each subject, the morphology and position of the TMJ were determined using cone beam computed tomography. RESULTS: Compared with before the treatment, the morphology of the condyle changed. The maximum cross-sectional area of the condyle in the axial plane and the condyle neck anteroposterior diameter in the coronal plane were reduced. The condylar apex height in the sagittal plane and the anterior condyle oblique inclination increased with statistically significant differences (all P<0.001). There were more patients who showed their condyles moving forward and their condyles in the middlee after the treatment compared with before the treatment, and with a statistically significant difference (P=0.002). The morphology of the glenoid fossa changed after the treatment. The articular eminence to the FH plane angle in the sagittal plane and the inclination of the posterior glenoid increased. The total height of the fossa increased with statistically significant differences (all P<0.001). CONCLUSION: TMJs can be adaptive to reconstruction. Orthodontic treatment shows a favorable efficacy in skeletal class ll deep overbite patients.

Logistic regression analysis of the relationship between abnormal dental occlusion and temporomandibular disorders in lower grade college students / 口腔疾病防治

Objective @#To investigate the influence of abnormal occlusion factors on the incidence of temporomandibular disorders (TMDs) in junior college students and to provide an etiological basis for the prevention and treatment of TMDs.@*Methods @# We examined the temporomandibular joint (TMJ) and dental occlusion in 754 lower grade college students (male 354, female 400) at Zunyi Medical University (Zhuhai campus). A questionnaire was also administered. We analyzed the correlation between TMD and the other three factors (static abnormal occlusion, dynamical abnormal occlusion and oral parafunctional activity) from the perspective of multivariate unconditioned logistic regression and univariate unconditioned logistic regression with dummy variables.@*Results @#The prevalence of TMD was 31.7%. The incidence of TMD was significantly (P<0.05) associated with sleep bruxism (OR=2.070), clenching (OR=2.553), diurnal (OR=2.642) and anterior teeth overbite (OR=1.228). Univariate unconditioned logistics regression analysis by dummy variables was used to analyze the incidence of TMD at different deep overbites (mild, OR=1.558; moderate, OR=2.189; severe, OR=3.236; P<0.05). @*Conclusion@#The risk factors for TMD in lower grade college students included anterior teeth occlusion, sleep bruxism, clenching, and diurnal treatment. Worse deep overbite might increase the risk of TMD.

Planejamento biomecânico 3D no tratamento da Classe II ­ como se beneficiar dos efeitos colaterais ­ relato de caso / 3D biomechanical planning in Class II treatment ­ how to benefit from side effects ­ case report

Resumo O tratamento ortodôntico em pacientes adultos, hoje, faz parte da prática clínica de rotina. A exigência estética, aumento da expectativa de vida e a acessibilidade ao tratamento ortodôntico fizeram com que a procura pelo tratamento ortodôntico por pacientes adultos aumentasse muito. O propósito deste trabalho é apresentar o planejamento tridimensional (3D) e a mecânica ortodôntica de correção da maloclusão de Classe II divisão 2 de Angle com sobremordida profunda e molares extruídos, por meio de um caso clínico. Em que foram utilizados os efeitos colaterais da mecânica de intrusão, associada ao arco de torque, a favor da correção anteroposterior, vertical, assim como a correção da extrusão dos molares superiores. Ou seja, foram utilizados sistemas de forças associados, a fim de facilitar e acelerar mecanicamente o tratamento. O planejamento do tratamento foi realizado com o programa T3D Occlusogram e DDP. (AU)

Abstract Orthodontic treatment in adult patients today is part of clinical practice routine. The aesthetic request, increased life expectancy and accessibility to treatment caused the demand for adult patients to increase exponentially. The purpose of this work is to present the threedimensional (3D) and orthodontic mechanics of the correction of Angle Class II division 2 malocclusion with deep overbite and extruded molars, through a clinical case, in which side effects of intrusion mechanics were used, associated to the torque arc in favor of vertical anteroposterior correction, as well as correction of the upper molars extrusion, that is, the use of associated force systems in order to facilitate and mechanically accelerate the treatment. Treatment planning was carried out with T3D Occlusogram and DDP program. (AU)

Relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Artículo de revisión / Relation between the Syndrome type II division 2 malocclusions and the temporomandibular joint dysfunction. Review article

Introducción: Los pacientes con el Síndrome de clase II división 2, además de presentar clínicamente una relación de molares y caninos en disto-oclusión, muestran una retroinclinación de los incisivos centrales superiores con proinclinación de los laterales y sobremordida profunda, lo cual puede llegar a convertirse en un factor de riesgo que provoca disfunción temporomandibular. Objetivo: Identificar la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Material y Métodos: Se realizó una revisión bibliográfica automatizada en las bases de datos de los sistemas MEDLINE, PubMed, Hinari y Google; se utilizó un total de 17 artículos. Desarrollo: Por las características clínicas de la oclusión en los pacientes con este síndrome, el rango de movimiento mandibular está limitado, y produce un efecto traumático que se relaciona con una posición de los cóndilos desplazados hacia atrás e intruidos en la fosa glenoidea. Este desplazamiento más distal produce la presión del espacio retrodiscal ricamente inervado y sería causa de inflamación de los tejidos circundantes y afectación de la función de la articulación por elongación de los ligamentos discales o adelgazamiento del disco que afecta el complejo cóndilo-disco. Conclusiones: Los estudios consultados muestran la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular, dada las características clínicas presentes en este síndrome, que afectan el funcionamiento de la articulación temporomandibular y que al sobrepasar las capacidades adaptativas del paciente producen la disfunción en la misma(AU)

Introduction: Patients with Syndrome type II division 2 malocclusions, besides presenting a clinically established relationship between molars and canines in a distal occlusion, show a retro-inclination of the upper front teeth with pro-inclination of the lateral incisors and a deep overbite, which can result in a risk factor of temporomandibular dysfunction. Objective: To identify the relationship between Syndrome type II division 2 malocclusions and the temporomandibular dysfunction. Material and Methods: A bibliographic review was carried out through a search of databases such as MEDLINE, PubMed, Hinari, and Scholar Google. A total of 17 articles were used. Development: Because of the clinical characteristics of the occlusion in the patients with this syndrome, the range of jaw movement is limited, producing a traumatic effect that is related with a position of the condyles displaced backward and with glenoid fossa intrusion. This more distal displacement produces the pressure of the richly innervated retrodiscal tissue, which could be the cause of inflammation of the surrounding tissues and the affectation of the joint function due to an elongation of the discal ligaments or a thinning of the disc affecting the disc-condyle complex. Conclusions: The studies conducted demonstrate the relationship between the Syndrome type II division 2 and the temporomandibular joint dysfunction, given the clinical characteristics that are present in this syndrome, which affect the functioning of the temporomandibular joint, and produce its dysfunction when exceeding the adaptive capacities of the patient(AU)

Full-mouth rehabilitation in a patient with inclined occlusal plane and reduced vertical dimension by an attrition: A case report / 대한치과보철학회지

A proper vertical dimension and a harmonious occlusal plane are essential to satisfy a patient esthetically and functionally. A maxillomandibular occlusal vertical dimension is determined by the elevators which repeatedly contracts to a certain length, and a tooth location is determined by a maxillomandibular vertical dimension. The patient of this case came in with the incongruity of the lips and the occlusal plane. The result of clinical test showed the lack of length of the lower anterior due to the reduction of vertical dimension, the deep overbite of anterior, the excessive attrition of anterior, and the incongruity of occlusal plane. After the diagnostic wax-up, the temporary restoration was installed, and final prosthesis was installed after 6 months. As a result, the patient obtained a functionally and esthetically satisfying result.

Class II Division 2 subdivision left malocclusion associated with anterior deep overbite in an adult patient with temporomandibular disorder

ABSTRACT The orthodontic treatment of patients with chief complaint of temporomandibular disorders (TMD) presents doubtful prognosis, due to the poor correlation between malocclusions and TMDs. The present case report describes the treatment of an adult patient with Angle Class II Division 2 subdivision left malocclusion associated with anterior deep overbite and TMD. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements to obtain the title of BBO Diplomate.

RESUMO O tratamento ortodôntico de pacientes com queixa principal de disfunção nas articulações temporomandibulares (DTM) apresenta prognóstico duvidoso, devido à baixa correlação entre as más oclusões e as DTMs. O presente relato de caso descreve o tratamento de um paciente adulto com má oclusão de Classe II, divisão 2, subdivisão esquerda, de Angle e sobremordida profunda, associadas à DTM. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Anterior deep bite malocclusion treated with connecticut intrusion arch: biomechanical consideration.

Most Class II division 2 malocclusion manifest a severe deep bite, the orthodontic correction of deep overbite can be achieved with several mechanisms one such mechanics is true intrusion of anterior teeth. Deep overbite correction by intrusion of anterior teeth affords a number of advantages which includes simplifying control of the vertical dimension and allowing forward rotation of mandible to aid in Class II correction. It also aid in correction of a high gingival smile line. This case report presents the patient of a 14-year-old boy with Class II division 2 subdivision malocclusion treated with connecticut intrusion arch and also highlights the biomechanical aspect of this appliance. Intrusion of anterior teeth is difficult. An appropriate, effective and clinically manageable biomechanical system is required. The treatment approach shown in this case can treat the deep overbite precisely with incisor intrusion. The article shows the versatility of Connecticut Intrusion Arch and by applying the sound biomechanical principles we can execute the planned mechanics with minimal side effects.

To Evaluate the Efficacy of Active-wing Appliance in Patients with Lingual Tipping Deep Overbite Malocclusion / 天津医药

Objective To investigate and evaluate the change and efficacy of Active-wing Appliance in patients with lingual tipping deep overbite of Angle classⅡdivision 2 malocclusion.Methods Twenty patients with lingual tipping deep overbite of Angle classⅡdivision 2 malocclusions were selected for our study. Among the twenty patients, fifteen are girls and five are boys, whose age are from 16.0 to 23.0 years old with average of 18.8 years old . The patients were treated with Active-wing technique and all of them were non-extracted.Cephalometric films were taken before and after treatment to assess the effect of treatment . Eleven angular and thirteen linear measurements were taken. Paired t test was performed to analyze and evaluate the effects before and after treatment. Results Active-wing Appliance have advantage of easy operat-ing with short treatment cycle for treatment of deep overbite of Angle class Ⅱ division 2 malocclusion. It only takes 11 months in average for the treatment. After treatment, mandibular plane angle were increased (23.00° ± 6.76° vs 21.59° ± 5.32°),overbite were decreased [ (1.02±0.81) mm vs (5.67±1.22) mm] to reach normal level;incisors were labial incline sig-nificantly with increased protrusion and inclination;Post treatment parameter improvement also include:U 1-NA distance in-creased (4.67±1.21 ) mm vs (1.24±1.37) mm;U1-NA angle increased (24.40°±6.36° vs 11.70°±6.87°);lower incisors were significantly intruded[ (37.16 ± 1.81) mm vs(38.90 ± 1.84)mm];L6-MP were extruded [(31.68 ± 2.87) mm vs (30.38 ± 3.45) mm]; The cuspid and molar relationships were changed from Class Ⅱ to ClassⅠ occlusion. Conclusion The Active-wing Appliance can quickly open overbite and correct incisor lingual tipping for Angle class II division 2 with lingual tipping deep overbite. It is easy to operate and has been improved as efficient and shortened treatment. Meanwhile, it also saves arch wire. The Active-wing Appliance is especially powerful for lingual tipping deep overbite. However, the deficiency in torque control of premolars might be noticed.

Force system of teeth produced by utility arch and rocking-chair arch for the orthodontic treatment of deep overbite analyzed by finite element method / 实用口腔医学杂志

Objective:To study the force system of teeth produced by utility arch and rocking-chair arch for the treatment of deep o-verbite.Methods:Finite element model of mandible,mandible teeth,edgewise brackets and arch was established,utility arch and rocking chair arch were applied respectively,the force direction and magnitude of molars and incisors was analyzed by ANSYS.Re-sults:When utility arch was used,incisors bear intrusive force and molars bear extrusive force.With the utility arch wire was giving intrusive force to canine,the intrusive force to incisors reduced,the extrusive force to the first molars increased.When adding the bracketed teeth,the intrusive force to incisors increased,but the extrusive force to the canines and the force direction of the molars changed.Conclusion:While the utility arch exerts intrusive pressing force to the canines,the intrusive force to the lateral incisors de-crease,therefore,pressing of canines shall be independently completed after completing pressing of incisors.Different application methods of rocking-chair arches will produce different force to teeth.With addition of teeth applied with rocking-chair arch,the force to lateral incisors and molars changes the most.

Stability of deep-bite correction: A systematic review.

OBJECTIVES: Deep bite occurs in about 15% to 20% of the US population. Currently, it is unknown which types of correction are most efficient or stable. The purpose of this systematic review was to investigate factors related to stability of deep-bite correction. MATERIALS AND METHODS: An electronic search of 4 databases was performed from January 1, 1966 to June 27, 2012. Studies were considered for inclusion if they reported on deep bite samples that underwent orthodontic treatment in the permanent dentition. Records were required at the initial, posttreatment, and 1-year posttreatment times. Hand searching of reference lists of the included studies was performed. Data were abstracted using custom forms, and risk of bias was assessed using a modified Newcastle-Ottawa Scale. RESULTS: Twenty-six studies met the inclusion criteria. Most were case series, with considerable potential for bias. The significant heterogeneity of the studies precluded meta-analyses, and only descriptive statistics and stratified comparisons were reported. On average, patients underwent significant overbite improvement during treatment, and most of the correction was maintained long-term. Across all studies, the mean initial overbite, posttreatment overbite, and long-term overbite were 5.3, 2.6, and 3.4 mm, respectively. Initial severity appeared to be related to long-term stability. However, this relationship was difficult to isolate from other factors. The length of follow-up did not appear to be related to the amount of relapse. CONCLUSIONS: Although the quality of the current evidence is not high, patients with deep-bite malocclusion appear to undergo relatively successful treatment, and most of the correction appears to be stable.

Má oclusão classe II, 2ª divisão de angle, com sobremordida acentuada / Angle class II, division 2, malocclusion with deep overbite

Este relato de caso descreve o tratamento ortodôntico de uma paciente adulta, portadora de uma má oclusão Classe II, 2ª Divisão de Angle, com sobremordida e curva de Spee acentuadas e que apresentava vestibuloversão do dente 12 e algumas recessões gengivais. A paciente foi tratada com exodontia dos primeiros pré-molares superiores e máximo controle de ancoragem. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 6, ou seja, uma má oclusão com sobremordida acentuada, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

This case report describes the orthodontic treatment of an adult patient, who presented a Angle Class II, Division 2, malocclusion, with overbite, severe curve of Spee, right maxillary lateral incisor proclined and gengival recessions. The patient was treated with extraction of the first premolars and maximum anchorage control. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) representing the category 6, deep overbite malocclusion, as part of the requirements for obtaining the title of Diplomate by BBO.