Deep Bite Treatment: Looking Beneath the Surface

Deep bite is an excessive overlap of incisors and should be treated in cases with gingival impingement or with long incisor guidance, that can lead to incisor wear. It is multifactorial in nature and can be associated with a decreased mandibular angle, incisor extrusion and/or posterior underdevelopment. Posterior tooth wear or erosion can also lead to deep bite due to loss of occlusal vertical dimension, mandibular counterclockwise rotation, and bite deepening. Many treatment approaches are available, which may include incisor intrusion, molar and premolar extrusion or posterior prosthodontic build ups. Esthetic and functional aspects will determine which treatment approach to use and should be considered in treatment planning, most specifically upper incisor display at rest and occlusal vertical dimension. A series of cases will be presented to illustrate and discuss different treatment approaches, pointing out important diagnostic criteria to define where and how deep bite should be treated.