[Orthodontic treatment of overbite by the Tip Edge technique in conjunction with an anterior bite elevator. Part 1]. / Traitement orthodontique de la supraclusion, par la technique Tip-Edge complétée par une plaque de surélévation antérieure. 1.

In orthodontics, incisor overbite has always been considered as an anomaly difficult to correct but also as the one most hindering the solving of the problems resulting from other associated malpositions. The recent concept of unlocking, introduced by the bioprogressive School, proves that the profession has become aware of its importance in any orthodontic treatment plan. Due to the fact that overbite also hinders the setting up of inferior brackets or forces the practitioner to bond them in a position liable to burden the parodontal health of the lower incisors has therefore induced the author to put in place, at the beginning of the treatment with the Tip-Edge technique, an anterior bite raiser thus generating space in the lateral sectors. Considering how fast the anterior problem is solved once the occlusion is lifted, the bite raiser can be suppressed within three months. Another advantage resides in the possible adjunction of an expansion screw also aimed at unlocking the occlusion in transverse direction. The question then raised in to know whether that approach which ought to be compared to the one of the functional appliances is not the ideal solution to unlock the occlusion in the three dimensions of space when the use of fixed appliances alone might be unsuitable or too slow, regarding current therapeutic aims. Attributing that spectacular therapeutic result to an incisor intrusion or a molar extrusion is of little interest as far as those alterations do not lead to an increase of the vertical dimension of the lower portion of the face. A cephalometric study, published concomitantly, has evidenced that the use of an anterior bite raiser together with the Tip-Edge technique only leads to perfectly similar alterations to those observed with the Ricketts bioprogressive technique or the Schudy edgewise technique, without the help of a bite raiser. From now on, integrating the bite raiser in our therapeutic armamentarium in conjunction with fixed techniques is highly recommended.

[Orthodontic treatment of overbite with an appliance for raising the anterior vertical dimension. Part 2]. / Supraclusion, traitement orthodontique par plaque de surélévation antérieure et dimension verticale. 2.

If incisor overbite in the matter of orthodontic treatment entails difficulties with the appliances due to excessive overbite of the incisors, involving an anterior bite raiser to enable the unlocking of the occlusion and the bonding of the brackets on the anterior mandibular teeth poses the problem of the vertical behavior of the masticatory apparatus during treatment. A profile teleradiograph was therefore taken at the beginning of treatment and again once the occlusion had been lifted due to the presence of the bite raiser and within a period of three months. The sample was separated in two groups according to the value of FMA; a first group was composed of 44 cases exhibiting an FMA angle inferior to 25 degrees therefore similar to the cases analyzed by Dake and Sinclair in 1989, called "reference group" and a group of cases exhibiting an FMA angle superior to 25 degrees. The aim of this study is indeed to confront, as regards vertical behavior, the therapeutic approach of the authors with the one studied by Dake and Sinclair dealing with cases treated with Ricketts and Tweed technique (Schudy modified). Following Dake and Sinclair's approach, the authors managed to find out in cases with FMA inferior to 25 degrees that the vertical alterations in the study group were not different from those in the reference group. This means that in spite of the presence of an anterior bite raiser the mandibular plane angle had only increased by 1.8 degree, compared to 1.8 degree for the Ricketts group and 1.1 degree for the Tweed/Schudy group. As for the study sample with an FMA angle superior to 25 degrees, the vertical alterations in the study group show an increase of the angle of the mandibular plane equal to 1.2 degree, here again the increase is similar to the one observed in the reference group. It can thus be concluded that the use of an anterior bite raiser in conjunction with the Tip-Edge technique is not only advisable but strongly recommended both to unlock the occlusion but also to enable bracket bonding at the very beginning of treatment.