BiTurbo2 system for rapid deep overbite correction

Fig. 1: Anatomy of BiTurbo2: The eight main characteristic features of the second generation BT2 are shown.

Figs. 2a & b: Severe overbite of 120 % associated with CNS-muscle hyperactivity and skeletal vertical mandibular overclosure (VMO). Freeway space at rest was excessive of 10 mm at the molars (Figs. 4a & b) where the norm is 3 mm.

Figs. 4a,b: Severity of the restriction of buccal segment eruption with the first CNS-muscle de-programmer.

Figs. 5a & b: A skeletal mandibular overclosure is characterised by a counter clockwise rotation of the mandible associated with CNS-muscle hyperactivity including clenching and parafunction that is ideal for BT2 application.

Figs. 5c & d: A deep overbite with wear of the cusp tips associated with CNS-muscle hyperactivity are shown in the Class II division 2 malocclusion on the patient’s left side.

Fig. 5e: Panoramic radiograph reveals the intrusive effect on the buccal segments classified as skeletal restriction of eruption, with CNS-muscle hyperactivity. Early periodontal bone loss is additionally observed.

Fig. 5f: Downward and backward rotation of the mandible during BT2 treatment that improves the initial severe chin protrusion.

Figs. 5g & h: Good harmony and balance are restored to the smile with a Class I functional occlusion and good incisor torque.

Fig. 6a: The mechanism of how BT2s work. Application of buccal rhomboid elastics with active SL is shown.

Fig. 6b: As the bite is opened with the application of BT2s, elastics in a rhomboid pattern are used posteriorly to erupt the buccal segments.

Fig. 3a: The fi rst generation BT1 was a rigid one-piece.

Fig. 3b: The BT1 prototypes are shown in test-polycarbonate with a positioning instrument used in the vertical groove.

Fig.3c: Anterior guidance is produced by the curved design of the BiTurbo2.

Fig. 3d: The vertical groove permits easier debonding when needed, than past solid form bite supports.

Fig. 4c: BiTurbos and active self-ligating brackets with rhomboid 1/4", 4.5 oz, combine with compensating curve in the upper arch and reverse curve of Spee in the lower arch for rapid bite correction from 120% (Figs. a,b) to 50 %.

Fig.7a: BT2s in Class III treatment are bonded to the lingual of the lower incisors to increase the vertical dimension and to permit the placement of the active self-ligating appliance on the labial of the upper incisors.

Fig.7b: BT2s in Class III treatment are bonded to the lingual of the lower incisors to increase the vertical dimension and to permit the placement of the active self-ligating appliance on the labial of the upper incisors.

Fig.7c: BT2s in Class III treatment are bonded to the lingual of the lower incisors to increase the vertical dimension and to permit the placement of the active self-ligating appliance on the labial of the upper incisors.

Fig.7d: BT2s in Class III treatment are bonded to the lingual of the lower incisors to increase the vertical dimension and to permit the placement of the active self-ligating appliance on the labial of the upper incisors.