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Revista Latinoamericana de Ortodoncia y Odontopediatría
Depósito Legal Nº: pp200102CS997 - ISSN: 1317-5823 – www.ortodoncia.ws
Página |1
Palatal composite bite blocks
 Dr. Akhter Husain

Professor and Head,Department of Orthodontics and Dentofacial Orthopaedics,
Yenepoya Dental College, Yenepoya University
 Dr. Vivek Amin

Professor,Department of Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental
College, Yenepoya University
Abstract
The clinician often faces the problem of bonding lower anterior teeth in deep bite cases as the occlusal forces can
easily debond the brackets, particularly if there is a prematurity of any of these brackets. Here is a very practical and
simple procedure to enable the fabrication of small precise composite bite blocks on the palatal aspects of upper
anteriors.
Key words: Bite Blocks, Deep Bite, customized for each patient.
INTRODUCTION
The bite blocks are used when bracket interference makes it difficult to bond the mandibular
anterior and posterior teeth's at the start of the treatment. Earlier bite planes were used in
class II division I and division II cases for the correction of deep bite with moderate overjet1.
Bite planes can be fixed (1,2,3,4) or removable(5) . Removable bite planes depend on patient
cooperation and can also cause mucosal trauma whereas the fixed bite blocks do not contact
the lower incisors uniformly.
The Palatal composite bite blocks (PCB) can be used to the following reasons.
1. They are absolutely customized for each patient.

2. It is done by using routine materials in Dentistry.
3. It gives an anterior bite plane effect.
Procedure
Step I:
The patient is clinically evaluated with an extent of deep bite and the amount of bite to be
raised. This can be done arbitrarily by bonding a bead of composite material on the occlusal
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Depósito Legal Nº: pp200102CS997 - ISSN: 1317-5823 - RIF: J-31033493-5 - Caracas - Venezuela
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surface of the lower first molar which can be fine-tuned by grinding of the composite till a
satisfactory vertical relation is established.
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Step II:
Impressions of both the arches are made using alginate. A wax bite registration is made
clinically which is transferred to the simple hinge articulator. Thereby recoding the desired
amount of bite opening required.
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Step III:
Small inlay or pattern wax blocks are placed on the palatal surfaces of the upper anteriors and
each one carved out as individualized platform in such a way that all anterior contact
simultaneously.
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Step IV:
A specialized tray is loaded with silicon putty and the impression is made only of the palatal
side.
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Take out the impression, wash and dry using a 3 way syringe. Load the depression caused by
the wax platform using restoration composite material.
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Step V:
The palatal aspects of teeth are prepared by etching and priming and the tray is transferred
back into the mouth positioned properly.
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A UV light is applied on the labial sides of the anterior till an initial set of the composite is
assured. The tray is removed again to confirm polymerization.
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Clinically, articulating paper is used to ensure uniform contacts of the lower anteriors on all the
platforms. Once this is done the patient is ready for the regular orthodontic strap up.
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Advantages:
1. Simple to use.
2. Customized individual anterior bite blocks.
3. Does not require patient compliance.
4. Uniform contact of the lower anterior on the platform.
5. Does not interfere with the mechanotherapy.
6. Helps to open bite (anterior bite plane effect).
References:
1. Philippe j. 1996 Treatment of deep bite with bonded bite planes. J Clin Orthod 1996; 30:396-400.
2. Heinrich CK.1993 A practical bite plane for use with fixed appliances. J Clin Orthod 1993; 27:508-10.
3. Madsen R.1998 Bonded acrylic lingual bite planes. J Clin Orthod 1998; 32:311-7.
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4. Jackson S, Sandler PJ.1996 Fixed bite planes for treatment of deep bite. J Clin Orthod 1996; 30:283-7.
5. Banks PA, Carmichael G.1998 Modified arrowhead clasps for removable bite planes. J Clin Orthod 1998;
32:377-8.

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Revista Latinoamericana de Ortodoncia y Odontopediatría

Depósito Legal Nº: pp200102CS997 - ISSN: 1317-5823 – www.ortodoncia.ws

Palatal composite bite blocks

 Dr. Akhter Husain

 Dr. Vivek Amin

1. They are absolutely customized for each patient.

2. Customized individual anterior bite blocks.

3. Does not require patient compliance.

4. Uniform contact of the lower anterior on the platform.

5. Does not interfere with the mechanotherapy.

6. Helps to open bite (anterior bite plane effect).

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