Clinical tip: Clinical considerations for Bite turbos(BT)
Anterior bite turbos are commonly used appliances in resolving deepbite. This presentation aims to highlight the important considerations of anterior torque and overjet in the application of bite turbos and recommends they are used in conjunction with Class ll elastics for occlusal stabilization.
Anterior bite turbos are advised to be placed once anterior teeth have sufficient lingual root torque. If the anterior teeth are too straight, the force of intrusion will result in a direct contact between the apical root and the buccal cortical bone. If the anterior teeth have an excessive overjet, the anterior bite turbos should initially be placed more apically instead of in the final position. If the distance between lower anterior teeth and anterior BT is too wide, it is straining for patients to move their mandible forwardly to occlude the anterior BT.
After the posterior teeth have complete intercuspation, the anterior BT can be moved incisally to the final position. A final reminder is the combined use of Class II elastics. The intermaxillary retraction of Class ll elastics will help anterior teeth occlude on the bite turbos and stabilize posterior occlusion .
摘要
咬合墊高物(bite turbo, BT)是一個經常用於解決深咬的套件，本次報告在分享使用BT時需考量前牙的torque(扭矩) 及 overjet(水平覆蓋)以及建議在墊BT時合併使用二類橡皮筋。在前牙有足夠的lingual root torque(舌側牙根扭矩)時，才可墊上BT。因為牙齒如果太直就黏上BT，下壓的力量(intrusion)會讓牙根尖直接撞擊到頰側皮質骨。
再來，在前牙的 overjet(水平覆蓋)太大時，我們會將BT黏在較靠近牙齦處而非一下就直接黏到最終的位置。當後牙的牙齒可以互相接觸時，我們會再次將BT往切端處移動到最終的位置。這是因為如果下頷前牙距離BT太遠時，為了讓下頷前牙和BT有很好的咬合，病人必須要很費力的前突下巴。最後，建議在墊BT時可以合併使用二類橡皮筋。上下頷藉由橡皮筋的互相牽引，可以幫助下頷前牙更穩定的咬在BT上。