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Evaluation of different methods of correcting deep bite in adult and adolescent patients: a systematic review and
Omar Ahmad Rasol1, Mohammad Y Hajeer2,3, Mohammad Khursheed Alam4
1University of Damascus, Damascus, Syrian Arab Republic.
Background:
A deep bite is a prevalent malocclusion, and its treatment remains one of the most debated topics in orthodontics due to the variety of underlying causes and the diverse orthodontic approaches employed to address it.
Objective:
This systematic review aimed to assess the evidence on the most effective approach for treating deep bites in adult and adolescent patients.
Search Methods:
A thorough search was performed up to January 2025 among these databases: PubMed®, the Cochrane Library, Scopus®, Web of Science™, Embase®, and Google™ Scholar.
Selection Criteria:
Only randomized controlled trials (RCTs) were included in this review on adult and adolescent patients with deep bite malocclusion who underwent any orthodontic treatment to correct this malocclusion.
Data Collection And Analysis:
The Cochrane tool (ROB2) was employed to assess the risk of bias, while the GRADE approach was used to evaluate the quality of evidence.
Results:
Eight RCTs were included in this review. Five of the eight studies were suitable for qualitatively synthesizing the data. The meta-analysis showed that the miniscrew-supported intrusion (MSI) caused a statistically significant amount of overbite reduction (mean difference (MD) = - 0.36 mm), upper incisor intrusion (MD = - 0.77 mm), and upper incisor proclination (MD = 0.63o) compared to the Connecticut intrusion arch (CIA), and the quality of evidence was low to moderate. Moderate-quality evidence indicated that there was no statistically significant difference between the anterior bite turbos (ABT) and the lower reversed curve of Spee (RCS) regarding overbite reduction (MD= - 4.07 mm, MD = - 3.27 mm, respectively). A low-quality evidence indicated that the MSI and the utility arch (UA) caused more overbite reduction than the J-Hook headgear (J-Hg) (MD = -2.33 mm, MD = - 2 mm, MD = - 0.8 mm, respectively). However, the MSI was superior regarding upper incisor intrusion than the UA and the J-Hg (MD = - 2.08 mm, MD = - 1.33 mm, MD= - 0.1 mm, respectively).
Conclusion:
Low-quality evidence suggests that MSI is superior to CIA for reducing overbite, and causing more upper incisor proclination. Moderate -quality evidence indicates that MSI is superior to CIA for intruding the upper incisors. Moderate-quality evidence indicates that the ABT and the RCS effectively reduce overbite. Low-quality evidence suggests that the MSI and the UA cause more overbite reduction and upper incisor intrusion than the J-Hook headgear, and the MSI causes more upper incisor intrusion than the UA.
Registration:
The protocol was registered in the PROSPERO database (CRD42025633739) during the first stages of the review.
