title: Asymmetric deep bite with a canted occlusal plane: a case report.
abstract: BACKGROUND
  Asymmetry and deep bite malocclusions provide management difficulties for clinicians and the combination invites special concern.
  
  
  OBJECTIVE
  The purpose of the present paper is to describe a clinical case presenting with an asymmetric deep bite, a canted occlusal plane, a Class II canine relationship on the right side and a Class III canine relationship on the left side, with deviations of both dental midlines to the right. A lower right premolar impaction contributed to the asymmetry and a left first maxillary molar extraction was required for endodontic reasons.
  
  
  METHODS
  A straight-wire technique was used for eighteen months to achieve second molar mesialisation, as well as dental levelling and alignment. To unravel the mandibular arch, resolve the deep bite and manage the canted the lower occlusal plane, two bite turbos were attached to the palatal surface of the maxillary central incisors. In addition, a sectiona Multiloop Edgewise Arch-Wire (MEAW) was placed on the left side and maintained for nine months. Different lower MEAW activation (lateral left lower extrusion) and tip-back control on the posterior teeth were essential mechanics to increase vertical dimension on the lower left side and allow for Class III dental correction. Short Class II vertical elastics on the right side and Class III elastics on the left side were applied.
  
  
  CONCLUSIONS
  The asymmetric mechanics allowed the case to be treated to a stable sagittal and vertical occlusal result.
authors.affiliation: Health Sciences Research Center (CICS), Superior Institute of Health Sciences - North, CESPU, Gandra, PRD, Portugal. teresa.pinho@iscsn.cespu.pt
authors.forename: Teresa
authors.initials: T
authors.lastname: Pinho
mesh_terms: D000293:Adolescent; D001641:Bicuspid / Q000473:pathology; D002508:Cephalometry / Q000379:methods; D003481:Cuspid / Q000473:pathology; D005260:Female; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D008963:Molar / Q000601:surgery; D016382:Orthodontic Appliance Design; D050793:Orthodontic Extrusion / Q000295:instrumentation; D009969:Orthodontic Wires; D057887:Overbite / Q000628:therapy*; D010347:Patient Care Planning; D014081:Tooth Extraction; D014087:Tooth Movement Techniques / Q000295:instrumentation; D014095:Tooth, Impacted / Q000628:therapy; D016896:Treatment Outcome