Removable anterior bite planes are a widely used treatment for managing deep bite, particularly in growing patients. These devices are designed to correct excessive overlap between the upper and lower front teeth by subtly adjusting how the teeth come together.
But is there a better way to use them?
Specifically, should these devices be worn all the time, even during meals, for faster and more effective results?
This week, we’re breaking down the results of this study, which compared two different wear protocols to determine how daily use impacts deep bite correction.
Keep reading to discover what the researchers found and what it could mean for future treatment approaches.
Our Summary
Deep bite, a condition where the upper front teeth excessively overlap the lower front teeth, often calls for early intervention in growing patients to harness their natural growth potential.
A common treatment for deep bite involves removable anterior bite planes, which primarily work by encouraging molar extrusion and slight incisor intrusion. Although full-time wear is typically recommended, there’s ongoing debate about whether the appliance should also be worn during meals to achieve the best results.
This clinical trial set out to compare two treatment protocols: wearing the bite plane during meals (F+M) versus removing it for meals (F−M). Researchers explored how daily wear duration influences the speed of deep bite correction.
The study focused on growing patients below cervical vertebral maturation stage CS6, with overbites exceeding 40%, Angle’s Class I or II molar relationships, and either normodivergent or hypodivergent growth patterns. Thirty-two children, with an average age of approximately 11 years, were randomly split into two groups of 16. Cephalometric radiographs were taken at the start and after achieving a normal overbite. Wear time was tracked using a TheraMon microsensor embedded in the bite planes, allowing researchers to analyse the link between wear duration and the rate of overbite correction.
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Findings
The study found that the average daily wear duration was significantly higher in the group who wore the appliance during meals (22.6 hours) compared to the group who did not wear the appliance during meals (19.4 hours).
However, both groups showed similar cephalometric changes, including molar extrusion and incisor inclination, with no significant differences in most parameters. That said, the group that wore the appliance during meals experienced a faster rate of deep bite correction (1.83 mm/month vs. 1.08 mm/month). A positive, exponential relationship was found between the daily duration of wear and the rate of overbite correction.
The study concluded that longer wear duration was associated with faster deep bite correction, with the group who wore the appliance during meals showing a more rapid improvement.
Study Limitations
Participants were aware of the sensor embedded in the bite plane, which may have improved their adherence to the wear protocols, as they knew their wear duration was being monitored (Hawthorne effect)
About Dr. Jamal
ODr. Jamal Giri is an orthodontist and associate professor at B.P. Koirala Institute of Health Sciences in Nepal. He obtained his orthodontic training from the Institute of Medicine, Tribhuvan University, Nepal, in 2014.
Currently pursuing a PhD at the University of Adelaide, Dr. Jamal’s research focuses on the genetic and environmental factors influencing malocclusion development. He also holds a postgraduate certificate in clinical education from the University of Edinburgh and a master’s in medical education from the University of Nottingham.Dr. Jamal teaches on the Diploma in Orthodontics and Dentofacial Orthopaedics at the London Dental Institute.
Read More
Sangwattanarat T, Thongudomporn U. Effectiveness of removable anterior bite planes with varied mealtime protocols in correcting deep bites among growing patients: a randomized clinical trial. The Angle Orthodontist. 2024;94(6).
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