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Maloklusi kelas 1 disertai Deep bite

Etiology
The etiology of deep overbite is a complex problem and may include one or more of the following:
Hereditary Skeletal Dental Muscular Habits

Penjelasan..
1. Hereditary and may follow a genetic pattern or familial condition. 2. Skeletal
An overgrowth or undergrowth of one or morealveolar segments. An excess of growth of the ramus and posterior cranial base permits the mandible to rotate upward. Thus Long ramus and short body with decreased gonial angle is characterstic feature Convergent upper and lower jaw bases Horizontal growth pattern or forward rotation or anticlock wise rotation of the of the lower jaw The four planes of the face (inraorbital ( FH Plane), palatal, occlusal, and mandibular) as seen from lateral roentgenograms arehorizontal and nearly parallel to each other.

3. Dental
Loss and/or mesial tipping of posterior teeth. In other words diminished posterior dental height Early loss of teeth and lingual collapse of the anterior teeth Overeruption of the incisor teeth, infraocclusion of the buccal segment or a combination of both. Overbite may because or accentuated by an aberration in the tooth morphology. Periodontal disease. Bite may deepen if the posterior tooth drift mesially during the pathological migration and worsen the existing condition When the teeth are reduced in size and number, the dental arches oppose less resistance against mandibular closure.

4. Muscular
The posterior vertical chain of muscles (masseter, internal pterygoid, temporal) is strong and attached anteriorly on the mandible and stretches in nearly a straight line vertically. The molars are directly under the impact of the masticatory forces of this chain. When the posterior vertical chain of muscles is strong and anteriorly positioned, a greater depressive action is transmitted to the dentition

5. Habits
a. lateral Tongue thrust swallow b. Finger sucking, c. Lip sucking
Sreedhar C, Baratam S. Deep overbiteA review (Deep bite, Deep overbite, Excessive overbite). Annals and Essences of Dentistry. 2009. vol I. issue 1. p 8-25.

Tahapan Diagnosa Orthodontik


Analisa Umum Analisa Lokal Analisa Fungsional Analisa Model Analisa Sefalometri Diagnosa dan Klasifikasi Maloklusi

Raharjo, Pambudi. Diagnosis Orthodontik. Airlangga University Press. Surabaya. 2011. edisi kedua. p1-97.

Analisa Umum
Status Px (Nama, Kelamin, Umur, dan Alamat) K dan U berkitan dgn pertumbuhkembangan dentomaksilofacial px. Keluahan Utamamyangkut keadaan susunan gigi geligi, yg dirasakan kurng baik seingga menggangu estetik dentofacial dan mempengaruhi status sosial serta fungsi pengunyahan. Catatan drg tdk boleh mengmbil kesimpulan yg spihak. Melainkan prwtan yg akan dilakukan sesuai dgn ap yg dibutuhkan px.
Raharjo, Pambudi. Diagnosis Orthodontik. Airlangga University Press. Surabaya. 2011. edisi kedua. p1-97.

Analisa Umum
Perlu diket. Jg keinginan px u/ melakukan prwtan orthodontik.
Motivasi ekternaortu atau tman dekat. Harus pnjlsan kpd px. Motivasi internadiri sendiri. Keberhasilan prwtn lbh bgus, krena px jauh lebih kooperatif. Keadaan sosial pxmnyangkut emosional px. Riwayat Kesehatan px dan keluarga. Berat dan tinggi badanmengthui pertumbuhanY normal sesuai dgn umur & jns kelamin. Ras

Raharjo, Pambudi. Diagnosis Orthodontik. Airlangga University Press. Surabaya. 2011. edisi kedua. p1-97.

Analisa Umum
Bentuk skeletal
Menurut sheldon(1940) terbagi menjadi 3 yaitu;
Ektomorfikorg yg langsing dgn sedikit jar. Otot atau lemak Mesomorfikorg yg berotot Endomorfikorg yg pendek dgn otot yg kurg berkmbg tetapi mmpunyai lap lemak yg tebal.

Ciri Keluarga Px Anak pxkt yg anak yg dpt menggangu pertumbuhan normal anak ex. Panas bdn yg tinggi dan sistemik >kualitas gigi daripd kuantitas pertmbhkembngan gigi.
Raharjo, Pambudi. Diagnosis Orthodontik. Airlangga University Press. Surabaya. 2011. edisi kedua. p1-97.

Analisa Umum
Alergibahan ortho yg digunakan Kelainan endokrin pascalahir percepata/perlmbtan pertumbuhn muka, mempngruhi drjat pematangan tulang, penutupan sutura, resorbsi akar gigi sulung dan erupsi gigi permanen. Membrn periodontal dan gusi sngt sensitif. Tonsil Kebiasaan bernafas.
Raharjo, Pambudi. Diagnosis Orthodontik. Airlangga University Press. Surabaya. 2011. edisi kedua. p1-97.

Analisa Lokal
Pmrx Estraoral
Bentuk kepalahub bentuk muka. BK (dolikosefali,mesosefali dan brakisefali) Simetri wajah Tipe wajahhub basis cranium. TW(leptoprosop, mesoprosop, dan euriprosop) Tipe profil kecembungan. Terbgi 3 yaitu cekung lurus dan cembung Bibirletak keseimbangan gigi. Fungsi bicarapngucapan huruf t, d, s, z Kebiasaan jelek mngisap ibu jari Keadaan jar periodontal OH Fase geligi Gigi yg ada Lidah palatum

Pmrx Intraoral

Raharjo, Pambudi. Diagnosis Orthodontik. Airlangga University Press. Surabaya. 2011. edisi kedua. p1-97.

Dst pd buku

Alat Yang digunakan


Labial Arch dan Bite plate or bite plane anterior. Labial arch Anterior Maxilaris, berfungsi mendorong gigi tersbut k labial atau retentif. bite plane gigi bagian Posterior mandibula akan supraekstrusi.
1. Abuabara A, Lago JCF. Treatment of deep bite with bite plate: a case report. Revista SulBrasileira de Odontologia (RSBO). 2007. v. 4. n. 2. p 63. 2. Yadav S, Karami JT. Review Articel: The essentials of Occlusal Splin Therapy. Stanford University. 2011. Vol 2 No1

Indikasi n kontra indikasi anterior bite plane


Indikasi
Muscle disorders related to orthopedic instability or an acute change in the occlusal condition.

Kerugiankalau tidak terkontrol mengakibatkan open bite.

Deshpande RG, Mhatre S. TMJ Disorders and Occlusal Splint Therapy A Review . INTERNATIONAL JOURNAL OF DENTAL CLINICS.2010.2 .(2):p22-29

Indikasi bite plane


Overbite berlebihan, Tmj yg terasa sakit akibat ganguan dimensi vertical Cross bite diregio anterior Mnghilgkan kebiasaan jelek s/t bruxism.

Features and Effect of deep over bite


Extraoral
Brachycephalic and europroscopic face. Facial esthetics is impaired (muscular face). Strong contractions of the masseter muscle can be seen in the face by clenching the teeth Straight to Mild convex profile Short anterior face height as measured from nasion to gnathion (fig 6) Diminished anterior lower face height. Short nose-chin distance. Normal distance from the chin to the incisal edge. The lips are thin and with an excess of lip height relative to face height. This gives a curled appearance of the lips . Mento labial sulcus :There is usually deep furrow, or sulcus, between the prominent chin and the lower lip Mandibular deficiency characterized by long mandibular ramus and short body, Square gonial angle, flat mandibular plane, prominent zygoma and prominent chin. Many of these features are common to class II div II a oral features( Fig. 9)
Sreedhar C, Baratam S. Deep overbiteA review (Deep bite, Deep overbite, Excessive overbite). Annals and Essences of Dentistry. 2009. vol I. issue 1. p 8-25.

Features and Effect of deep over bite


Intraoral The maxillary dental arch is broad, with often a maxillary bucccal cross-bite May involve a group of teeth or whole dentition. In skeletal deepbites the patient may exhibit gummy smile if there is clockwise rotation of maxilla . When the problem is in the anterior maxillary region, the patients often show excessive gingival tissue during smiling or event while speaking even when the upper lip is of adequate length ( fig 8) The palatal vault is flat. The presence of deep bite may cause palatal grooving by the indentations caused by lower anteriors. The dentition exhibits a tendency to small teeth prone to abrasion and a high increased percentage of congenitally missing teeth. Although teeth tend to spaced, a crowding of lower incisors may be present as a result of the deep bite. A deep curve of Spee in lower arch or a reverse curve of Spee in the maxillary dentition(Fig 2) Occlusal functions become impaired. Often the maxillary incisors are tipped lingually in Angle's Class II, division 2 pattern ( Fig 7)

Sreedhar C, Baratam S. Deep overbiteA review (Deep bite, Deep overbite, Excessive overbite). Annals and Essences of Dentistry. 2009. vol I. issue 1. p 8-25.