Mesial bite

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A mesial bite (class III according to Angle ) is a misalignment of the upper and lower jaw ( tooth misalignment ), whereby the upper jaw lies behind the lower jaw ( underbite ), the opposite is the distal bite (class II).

General and causes

In the case of a mesial bite, a distinction is made whether it is a

  • unilateral anatomical misalignment,
    • In this case, either the upper or the lower jaw has grown incorrectly. Incorrectly grown means that the lower jaw has overgrowth ( progeny ) or the upper jaw is incorrectly developed ( opisthognathy ).

or whether it is a

  • is a bilateral anatomical misalignment.
    • If the upper and lower jaw are incorrectly positioned, i.e. too far inside and too far outside, with the lower jaw always in front of the upper jaw. This happens when there is an overgrowth in the lower jaw and the upper jaw has not developed sufficiently.

A mesial bite can be very uncomfortable for those affected. On the one hand it is an aesthetic problem, which can be very annoying, especially when smiling, and on the other hand it is a hardly mechanical problem, since food cannot be chewed properly .

treatment

A mesial bite can be treated. If the cause of the misalignment is solely due to a misaligned tooth (dental cause), the treatment is usually carried out by correcting the tooth position with braces. If, on the other hand, the mesial bite is caused by a malformation of the jawbone (skeletal cause), orthodontic treatment as early as possible is advisable in childhood, because a skeletal mesial bite can only be repaired surgically after growth has finished. This treatment can last two to four years and consists of a combined orthodontic and surgical treatment. The surgical procedure is performed under general anesthesia . Before the operation (the longest part of the treatment) a preparation of the tooth position must be made; a brace is usually used for this . This is important because the position of the teeth in the lower jaw must match the position of the teeth in the upper jaw, otherwise the teeth will not mesh properly after the operation . As soon as the orthodontist is of the opinion based on plaster models that the upper and lower jaw will fit together after the operation, the oral surgeon can operate. Then the “fine adjustment” of the toothing takes place again with braces.

Prevention and early treatment

A manifest mesial bite can and should be treated (functional) orthodontically from the age of 4 to 5. z. B. with the proven function regulator  3 according to Fränkel or with reverse thrust double plates (from approx. 6 years) the growth of the upper jaw is stimulated and at the same time that of the lower jaw is inhibited. Successes have also been achieved with the corresponding splint activators or Bimler type C-type bit formers . However, it is difficult to predict whether surgical correction will be required later. Since the mesial bite is genetically determined, a family history can be helpful. In addition, a lateral cephalometric image can be used to predict growth trends in the lower jaw.