What to bear in mind when correcting a deep bite

In this post we are going to talk about what we have to bear in mind when correcting a deep bite and how it relates to smile design.

To correct a deep bite we can normally carry out a vertical movement of the lower incisors (known as intrusion) or a vertical movement of the upper incisors (also known as intrusion).

When we set out to correct a deep bite, we have to consider not only what effect it will have on the patient’s bite but also what effect those vertical movements will have on the soft tissue and, consequently, on the look of the smile.

In this case we decided to correct the deep bite mainly by intruding the upper arch. Look at how the patient appeared before starting her treatment.

What we have done is:

1. Improve the relationship between the four incisors. As you can see in the initial photograph, there is a large step between the central and the lateral incisors. By correcting the deep bite with intrusion of the upper central incisors, we have reduced the step between the central and lateral incisors, improving the relationship between them. We have also greatly improved the relationship between the lips and the teeth, achieving greater harmony.
2. Improve the relationship between the four incisors. As you can see in the initial photograph, there is a large step between the central and the lateral incisors. By correcting the deep bite with intrusion of the upper central incisors, we have reduced the step between the central and lateral incisors, improving the relationship between them.
3. We have also greatly improved the relationship between the lips and the teeth, achieving greater harmony.

To carry out that vertical movement we needed to create space, since one of the keys to success in this case lies in correct development of the arch. That means we gave the arch the right shape, which allowed us to carry out vertical movement at the front.

By developing a correct arch form we have been able to design a much fuller smile, what is known as a Full Mouth Smile. At the same time, by increasing the expansion of the arch and the torque, we have also considerably reduced and improved the posterior gummy smile.

In the final result, as you can see in the photograph below, we have solved the occlusal problem and the deep bite the patient had. We have also designed a full smile and achieved a perfect lip-to-tooth relationship.

This case was prepared by Dr. Diego Peydro