Stability of deep-bite correction: A systematic review

Deep bite occurs in about 15% to 20% of the US population. Currently, it is unknown which types of correction are most efficient or stable. The purpose of this systematic review was to investigate factors related to stability of deep-bite correction.

An electronic search of 4 databases was performed from January 1, 1966 to June 27, 2012. Studies were considered for inclusion if they reported on deep bite samples that underwent orthodontic treatment in the permanent dentition. Records were required at the initial, posttreatment, and 1-year posttreatment times. Hand searching of reference lists of the included studies was performed. Data were abstracted using custom forms, and risk of bias was assessed using a modified Newcastle-Ottawa Scale.

Twenty-six studies met the inclusion criteria. Most were case series, with considerable potential for bias. The significant heterogeneity of the studies precluded meta-analyses, and only descriptive statistics and stratified comparisons were reported. On average, patients underwent significant overbite improvement during treatment, and most of the correction was maintained long-term. Across all studies, the mean initial overbite, posttreatment overbite, and long-term overbite were 5.3, 2.6, and 3.4 mm, respectively. Initial severity appeared to be related to long-term stability. However, this relationship was difficult to isolate from other factors. The length of follow-up did not appear to be related to the amount of relapse.

Although the quality of the current evidence is not high, patients with deep-bite malocclusion appear to undergo relatively successful treatment, and most of the correction appears to be stable.