Intrusion of Molars Using TSADs: The Key Element to Correct Vertical Excess With or Without Open Bite
Vertical excess, or simply long face, along with high mandibular plane angle can be treated with ‘double arch intrusion’ using TSADs. When a molar tooth is intruded, whether it is located in the upper arch or lower arch, the opposing molar will extrude. That is the reason why a ‘double arch intrusion’ is necessary when you try to close the mandibular plane angle. If a patient with vertical excess shows an open bite, anterior coupling can be achieved only by intruding the molars. However, if the patient has a normal bite, intrusion of the molars will induce the premature contacts in the anterior teeth. In this case, whole arch intrusion of both molars and anterior teeth is recommended. In addition, the construction process of the system using TSADs will be thoroughly discussed.
Learning Objectives
- Understand that to close the mandibular plane angle of the vertical excess cases, double arch intrusion using TSADs is necessary. Upper dentition is intruded using mid-palatal TSAD and lower dentition is intruded via buccal TSADs.
- For treating the vertical excess patient with open bite, it is sufficient to correct the open bite when you intrude molars using TSADs. The anterior teeth will be automatically occluded and the mandibular plane angle will be closed.
- For treating vertical excess patient without open bite, it is recommended to intrude not only the molars but the anterior teeth. Then, which side of anterior teeth do you intrude, upper or lower? It is usually decided by the upper incisal display.
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