How to fix a deep overbite in wear patients

Deep overbites are a common condition in patients with lingual wear of their maxillary incisors and facial wear of the mandibular incisors. The deep overbite can occur from three different etiologies.

First, as the teeth wear, the maxillary anteriors may erupt deepening the overbite with no change in vertical dimension.

Second, the mandibular anteriors may erupt with the same outcome.

Third, the patient may have had minimal eruption of the anterior teeth but a loss of vertical dimension as the tooth wear progressed; however, this patient must show wear on the posterior teeth or loss of the posterior teeth for the vertical dimension to have changed.

Patients that display this pattern of wear and a deep overbite from any of the three causes will also have extremely thin teeth that are still in occlusion. This makes restoration next to impossible because any tooth preparation to create space results in the removal of almost all the tooth structure. If this condition isn’t corrected the teeth will undoubtedly keep wearing away.

In order to deliver the most effective and conservative treatment you must evaluate whether the maxillary or mandibular incisors may have erupted secondary to the wear, in which case orthodontic intrusion or crown lengthening should be performed which will create the space to restore the teeth. If it appears the anterior position is correct, then opening the vertical dimension may be necessary to gain the needed space.

So, how do you know which correction needs to be performed? Follow these four steps.

Reprinted with permission from Spear Education.