INNOVATIVE TEMPORARY BITE RAISING APPLIANCES USED IN ORTHODONTICS

Vinit Swami MDS*, Dr. Vasanthi Swami MDS, Dr. Anand Sabane MDS, Amol Patil MDS, PhD4

ABSTRACT

A 21 years old male patient reported for correction of palatally blocked out canine. The treatment plan consisted of fixed appliance treatment with 022 MBT pre-adjusted edgewise appliance. Correction of palatally blocked out canines (as seen in Figure 1) in adults can pose a problem in aspects of patient tolerance to various appliances like bite plates and /or bite blocks, given to provide occlusal clearance for the tooth to be moved buccally. Several appliances both fixed and removable have been utilized for this purpose, including anterior or posterior bite splints, bonded lingual bite planes and bonded occlusal composite resin build-ups.[1,2, 3] These appliances have some limitations. Bite splints require impressions, laboratory procedures, and extra appointments for insertion and monitoring. Removable plates require patient compliance[4]. Bonded lingual bite planes can’t be adjusted and are difficult to remove. Composite resin bite-blocks require additional clinical time and may cause occlusal enamel wear of opposite teeth if filled composite resins are used.[5] Also in cases of bruxism, composite may wear down making it ineffective, requiring extra clinical time to restore it to the appropriate height.1 As proposed by Fine, bonding lingual brackets to the maxillary central incisors causes opening of bite but its use should be limited to Class I or Class II division 2 cases with minimal overjet.[6] Further, these lingual brackets can be fragile similar to the mandibular labial brackets they are supposed to protect. Güray (1999) introduced a new type of bite-opening appliance, the temporary bite raiser.[7] Its main disadvantage is that it does not allow headgear or auxiliary wires to be placed simultaneously.[1]

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