Biomechanics Strategies for Space Closure in Deep Overbite

Abstract

Space closure is an interesting aspect of orthodontic treatment related to principles of biomechanics. It should be tailored individually based on patient's diagnosis and treatment plan. Understanding the space closure biomechanics basis leads to achieve the desired treatment objective. Overbite deepening and losing posterior anchorage are the two most common unwanted side effects in space closure. Conventionally, correction of overbite must be done before space closure resulted in longer treatment. Application of proper space closure biomechanics strategies is necessary to achieve the desired treatment outcome. This cases report aimed to show the space closure biomechanics strategies that effectively control the overbite as well as posterior anchorage in deep overbite patients without increasing treatment time. Two patients who presented with class II division 1 malocclusion were treated with fixed orthodontic appliance. The primary strategies included extraction space closure on segmented arch that employed two-step space closure, namely single canine retraction simultaneously with incisors intrusion followed by enmasse retraction of four incisors by using differential moment concept. These strategies successfully closed the space, corrected deep overbite and controlled posterior anchorage simultaneously so that the treatment time was shortened. Biomechanics strategies that utilized were effective to achieve the desired treatment outcome ABSTRAK Strategi biomekanika penutupan ruang pada tumpang gigit dalam. Penutupan ruang dalam perawatan ortodonti merupakan aspek yang menarik berkenaan dengan prinsip-prinsip biomekanika. Dibuat khusus secara individu berdasarkan diagnosis dan rencana perawatan. Pemahaman dasar-dasar biomekanika penutupan ruang akan meningkatkan kemampuan operator untuk mencapai tujuan perawatan yang diinginkan. Efek samping yang paling sering terjadi dalam penutupan ruang adalah bertambah dalamnya tumpang gigit dan hilangnya penjangkaran posterior. Umumnya tumpang gigit dikoreksi sebelum penutupan ruang, sehingga waktu perawatan menjadi lebih lama. Untuk mengatasi masalah-masalah tersebut, diperlukan penerapan strategi biomekanika penutupan ruang yang tepat untuk memperoleh hasil perawatan yang sesuai harapan. Tujuan laporan kasus-kasus ini adalah untuk menunjukkan penerapan strategi biomekanika yang efektif untuk mengontrol tumpang gigit dan penjangkaran posterior pada pasien dengan tumpang gigit dalam, tanpa memperpanjang waktu perawatan. Dilaporkan dua kasus maloklusi kelas II divisi 1 yang dilakukan perawatan alat ortodonti cekat. Strategi utama meliputi penutupan ruang pencabutan di lengkung segmental dalam dua tahapan yaitu retraksi kaninus secara individu dengan intrusi insisivus secara simultan, diikuti dengan retraksi empat insisivus dengan menggunakan konsep momen diferensial. Dengan strategi ini, dapat dilakukan penutupan ruang, perbaikan tumpang gigit dalam, dan pengendalian penjangkaran posterior dalam waktu bersamaan, sehingga diperlukan waktu perawatan yang lebih singkat. Strate...

Management of Angle Class I Malocclusion with Severe Crowding and Bimaxillary Protrusion by Extraction of Four Premolars: A Case Report

“…In extraction in deep overbite cases, leveling and alignment of the anterior teeth do not correct the deep overbite, and therefore, it must be corrected to ensure that full space closure is possible. 10 The closing of extraction spaces can be performed using two main retraction techniques: en masse retraction (ER) or two-step retraction (TSR). For space closure achieved by ER, incisors and canines are retracted in just one step as if it were a single block.…”