Deep Bite Malocclusion: A Comprehensive Review of Epidemiology, Etiology, Clinical Consequences, and Treatment Approaches

  • Home
  • Deep Bite Malocclusion: A Comprehensive Review of Epidemiology, Etiology, Clinical Consequences, and Treatment Approaches

Deep Bite Malocclusion: A Comprehensive Review of Epidemiology, Etiology, Clinical Consequences, and Treatment Approaches

Elif Sağır
Department of Orthodontics, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
ABSTRACT 

Deep bite, defined as excessive vertical overlap of the maxillary incisors over the mandibular incisors, is a highly prevalent and persistently challenging malocclusion, with reported prevalence ranging from 8.4% to 51.5% across populations. It is a clinical presentation rather than a single diagnosis, arising from dentoalveolar causes, an underlying hypodivergent skeletal growth pattern, or both, and its clinical consequences extend beyond occlusion to palatal and gingival soft-tissue trauma, accelerated incisal wear, and an association with signs of temporomandibular disorder. Effective management therefore requires distinguishing dental from skeletal etiology and identifying whether posterior extrusion, incisor intrusion, or both are indicated. In growing patients, anterior bite planes, bite turbos, and functional appliances exploit posterior dentoalveolar eruption to reduce overbite. In adolescents and adults, curve of Spee leveling with continuous archwires corrects the bite mainly through premolar and molar extrusion, whereas segmented intrusion arches, temporary anchorage device (TAD)-supported intrusion, and clear aligner therapy allow more direct incisor intrusion; recent meta-analyses show TAD-supported intrusion produces statistically greater, though often modestly larger, overbite reduction than conventional arches. Severe skeletal deep bite in nongrowing patients may require combined orthodontic-surgical treatment, including anterior segmental osteotomy. Long-term data indicate most corrections remain substantially stable, although partial relapse toward the original overbite is common. This review synthesizes epidemiological, etiological, clinical, and treatment-related evidence on deep bite malocclusion.

 

KEYWORDS

deep bite; deep overbite; etiology; temporomandibular disorders; periodontal trauma; curve of Spee; incisor intrusion; orthognathic surgery; review

 

REFERENCES

1) Angle EH. Classification of malocclusion. Dental Cosmos. 1899;41(3):248-264.
2) Watted N, Lone IM, Zohud O, Midlej K, Proff P, Iraqi FA. Comprehensive deciphering the complexity of the deep bite: insight from animal model to human subjects. J Pers Med. 2023;13(10):1472.
3) Bjork A, Skieller V. Facial development and tooth eruption: an implant study at the age of puberty. Am J Orthod. 1972;62(4):339-383.
4) Zimmer B, Seifi-Shirvandeh N. Changes in gingival recession related to orthodontic treatment of traumatic deep bites in adults. J Orofac Orthop. 2007;68(3):232-244.
5) Tinastepe N, Oral K. Investigation of the relationship between increased vertical overlap with minimum horizontal overlap and the signs of temporomandibular disorders. J Prosthodont. 2015;24(6):463-468.
6) Burstone CR. Deep overbite correction by intrusion. Am J Orthod. 1977;72(1):1-22.
7) Bernstein RL, Preston CB, Lampasso J. Leveling the curve of Spee with a continuous archwire technique: a long-term cephalometric study. Am J Orthod Dentofacial Orthop. 2007;131(3):363-371.
8) Rasol OA, Hajeer MY, Sultan K, Ajaj MA, Burhan AS, Jaber ST, et al. Evaluation of the best method for orthodontic correction of skeletal deep bites in growing patients: a systematic review. Cureus. 2024;16(6):e62666.
9) Atik E, Kocadereli I. Treatment of Class II division 2 malocclusion using the Forsus fatigue resistance device and 5-year follow-up. Case Rep Dent. 2016;2016:3168312.
10) Rozzi M, Tiberti G, Mucedero M, Cozza P. Leveling the curve of Spee: comparison between continuous archwire treatment and Invisalign system: a retrospective study. Am J Orthod Dentofacial Orthop. 2022;162(5):645-655.
11) Atalla AI, AboulFotouh MH, Fahim FH, Foda MY. Effectiveness of orthodontic mini-screw implants in adult deep bite patients during incisor intrusion: a systematic review. Contemp Clin Dent. 2019;10(2):372-381.
12) Bardideh E, Tamizi G, Shafaee H, Rangrazi A, Ghorbani M, Kerayechian N. The effects of intrusion of anterior teeth by skeletal anchorage in deep bite patients: a systematic review and meta-analysis. Biomimetics (Basel). 2023;8(1):101.
13) Rasol OA, Hajeer MY, Alam MK, Jaber ST, Kara-Boulad JM, Jaber S. Evaluation of different methods of correcting deep bite in adult and adolescent patients: a systematic review and meta-analysis. Prog Orthod. 2025;26:37.
14) Bell WH, Jacobs JD, Legan HL. Treatment of class II deep bite by orthodontic and surgical means. Am J Orthod. 1984;85(1):1-20.
15) Huang GJ, Bates SB, Ehlert AA, Whiting DP, Chen SS, Bollen AM. Stability of deep-bite correction: a systematic review. J World Fed Orthod. 2012;1(3):e89-e86.

 

Cite this article

Sağır, E. (2026). Deep Bite Malocclusion: A Comprehensive Review of Epidemiology, Etiology, Clinical Consequences, and Treatment Approaches. INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH, 5(9), 889-894. https://doi.org/10.58806/ijhmr.2026.v5i9n04

  • Share

Leave a Reply

Your email address will not be published. Required fields are marked *