Bite Planes and Lip Bumper

SCHOOL OF MEDICINE
DEPARTMENT OF DENTAL SCIENCES

ORTHODONTIC 3
CAT 2
BITE PLANES AND LIP BUMPER
NAME REGISTRATION NUMBER

Qamar Dakane BDT/2022/44840
Victor Bamgmboye BDT/2021/87110
Deborah Nyakibah BDT/2021/96032
Eric Muthomi BDT/2021/83961
Arnold Biko BDT/2021/95281
Breven Nyakina BDT/2021/93686
Watiri Trizah BDT/2021/94719
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TABLE OF CONTENTS
Preface..............................................................................................3
Introduction ....................................................................................4
Bite planes.......................................................................................4
Definition ..................................................................................4
Anterior bite plane.......................................................................4
Fabrication of anterior bite plane..................................................5
Posterior bite plane.......................................................................6
Fabrication of posterior bite plane................................................6
Lip bumper........................................................................................7
Definition ................................................................................7
Components .............................................................................7
Types........................................................................................7
Indications ..............................................................................8
Fabrication...............................................................................8
Effects .....................................................................................9
Clinical management...............................................................9
Conclusion.........................................................................................9
Reference...........................................................................................10
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PREFACE
In the realm of orthodontics and dental appliances, the concepts of bite planes and lip
bumpers stand as pillars of innovation and treatment efficacy. As we delve into the intricacies
of these devices, we embark on a journey to understand their profound impact on dental
health and orthodontic correction. Within these pages, we unravel the complexities of their
design, explore their diverse applications, and illuminate their roles in fostering optimal oral
function and alignment. From their humble beginnings to their modern iterations, the
evolution of bite planes and lip bumpers mirrors the evolution of orthodontic care itself. Join
us as we uncover the principles, practices, and possibilities encapsulated within these
indispensable tools of the dental profession.
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INTRODUCTION
The term ‘bite plane’ is often synonymous with anterior maxillary bite plane although they
can be used in the anterior as well as posterior region and in mandibular arch as well. Bite
plane has been used in the maxillary arch as early as 1879 to facilitate supraeruption of the
mandibular posterior teeth.
BITE PLANES
DEFINITION
A bite plane is a shelf of acrylic added to the base plate in the anterior or posterior region to
clear the occlusion or to reduce the over bite respectively. They are temporary devices placed
in the mouth to disocclude the teeth. These are removable or fixed appliance that can be
placed in the Anterior or Posterior segment depending on individual treatment
Anterior bite plane

Anterior bite plane are used when the occlusion interferes with tooth movement, when there
is severe deep bite in horizontal pattern of growth and in temporomandibular disturbances
resulting from over closure of the mandible. They are usually flat and parallel to the occlusal
plane. The maxillary anterior bite plane works on the principle that sufficient disocclusion of
the posterior segment will facilitate vertical eruption of the mandibular molars, help achieve
adequate vertical height and bite opening without significantly changing the occlusal
relationships. Supraeruption of the posterior teeth and growth of the surrounding alveolar
bone takes place. The new bone thus formed must be stabilised adequate by gradual
withdrawal of the bite plane to prevent relapse.
Examples are
 Hawley appliance with bite plane. This consists of labial bow and Adam’s clasps and
the acrylic part covering the palatal surface of the maxillary anterior teeth.
 Bite turbo. This is a small brackets attached to the back of the front teeth to align the
teeth and also prevent the patient from biting the lower brackets and breaking the
braces.
 Sved bite plane. This is ab appliance used to treat bruxism
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The mandibular anterior bite plane is used in the correction of maxillary anterior teeth in
cross bite. It is otherwise called the ‘lower anterior inclined plane’ or ‘Catalan’s appliance.’
Examples are
 Catalan’s appliance
 Composite resin lower inclined bite
FABRICATION OF ANTERIOR BITE PLANE

1. Impression taking both upper and lower teeth.
2. Model fabrication- dental stone is poured into the Impression and cast is made.
3. Articulation of the cast-both models are mounted on an articulator to simulate patient
jaw movements.
4. Design and fabrication-the anterior bite is design according to patient needs. the
anterior bite plane is designed in wax pattern. It typically consists of a flat platform
that covers the biting surfaces of the front teeth (anterior teeth). The appliance is
custom-made to fit the patient's dental arches comfortably.
5. Acrylic fabrication- the acrylic material used is either self cure or heat cure resin. In
heat cure the wax pattern is dewaxed, packed and cured in a curing bath.
6. Finishing and Polishing- the appliance is trimmed finished and polished and then
delivered to the patient.
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Posterior bite plane
It is a shelf of acrylic added to the baseplate covering the molar and premolar teeth. It breaks
the tooth lock in the anterior region by acting as a wedge between the maxillary and
mandibular teeth in the posterior region.
Examples are
 Bonded hyrax
 Hawley appliance with expansion screws
 Hawley appliance with z spring
Maxillary posterior bite planes are indicated in
1. reversed overjet (anterior crossbite)
2. unilateral or bilateral posterior crossbite.
The mandibular posterior bite plane in used to disocclude the maxillary and mandibular teeth
is case of palatally blocked out maxillary anterior teeth.
Examples are
 Fixed Mandibular Posterior bite plane
FABRICATION OF POSTERIOR BITE PLANE

1. Impression taking for both the upper and the lower dental arches of the patient using
alginate or silicone material.
2. Model fabrication- dental stone is poured into the Impressions and a cast is made for
the upper and lower patient’s dental arches.
3. Articulation – patient’s lower and the upper models are articulated to simulate jaw
movements.
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4. Designing the Bite Plane based on dentist assessment and whether creating a flat or
slightly inclined surface to provide even contact.
5. Acrylic resin or any other suitable material is applied to the model according to
designed shape and build up to the desired thickness and contours to ensure proper fit.
The acrylic covers on the occlusal surface of the posterior teeth.
6. After the material has set, the appliance is trimmed, finished and polished ready for
delivery
LIP BUMPER
DEFINITION
This is a fixed functional orthodontic appliance that works by altering the equilibrium
between the cheeks, lip and tongue and by transmitting forces from perioral muscles to the
molars when it’s applied.
Components
It has a removable part and a fixed part
a) The fixed part is composed of 2 molar bands cemented to first molars with 0.045inch
tube
b) The removable part is a stainless steel wire with u loop that runs in the lower vestibule
from molar to molar between teeth, lips and cheek
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c) The acrylic pad
Types
Cetlin has described 2 different lip bumpers
1) Custom made for each patient which has 2 loops at the molar level that allows
modification of the appliance therapy
2) Pre-formed and it’s available in different sizes and has 4 loops 2 at the molar level and
2 at the canine level
Indications
It’s indicated for various purposes
 Molar anchorage
 Interception of abnormal habit
 Space gaining in the lower arch
The lip bumper can be positioned at 3 levels of incisor crown

i. Incisal edge. This position is used to upright medially inclined molars because the
lower lip tends to lift the anterior part of the bumper creating a long level effect on the
molars
ii. Middle third. This is the position to use when shielding effects on incisors is desired.
The loop is kept away from the teeth altering the equilibrium in favour of the tongue
and the incisors slowly translate labially
iii. Gingival level. This is used to maintain the position of corrected molars and incisors.
The lip bumper must be kept close to the incisors.
FABRICATION OF A LIP BUMPER
1. Impression taking and making a cast of the lower model
2. Construction of a labial bow extending to the molars
3. Bands are placed on the first permanent or second deciduous molar with a
horizontal buccal tubes soldered to receive 0.9mm wire or the labial wire
assembly can be soldered directly to the band
4. Anterior portion of the wire from canine to canine is reinforced with acrylic resin
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5. Removable lip bumper retained by Adam’s clasp can be used when the patient
compliance is assured
Effect of lip bumper

i. Flaring of the incisors
ii. Increasing arch length desired through passive lateral and anterior expansion and
upright the lower molar distally adding the the available arch length
iii. According to Gerbers, in patient with very hypertonic soft tissue the lip bumper is
the appliance of choice.
Clinical management
 Appliance can be tied to molar hook with elastic chain
 If lip bumper is well fitted ; red lines can be seen on the inside of cheek and lips
where the wire runs
 Must keep the cheeks and lip away from the lower dental alveolar area
 Patient with the appliance must be monitored to avoid food impaction
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CONCLUSION
In conclusion, both bite planes and lip bumpers play vital roles in improving oral health and
addressing dental issues such as bruxism, TMJ disorders, dental crowding, and misalignment.
These appliances exemplify the diverse approaches employed by dental professionals to
enhance dental function and promote overall oral well-being.
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REFERENCE
 Orthodontic current principle and techniques (Garber, vanarsdall,vig?)
 Lip bumper therapy fir gaining arch length Am orthod dentofac orthop 1991
 Jackson s Sandler pj fixed bite planes for treatment of deep bite J clin orthod 1996
 Gender A, Hirshfield L. Minor tooth movement in general practices 3rd Ed.mosby Co.
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SCHOOL OF MEDICINE

DEPARTMENT OF DENTAL SCIENCES

NAME REGISTRATION NUMBER

Anterior bite plane

FABRICATION OF ANTERIOR BITE PLANE

FABRICATION OF POSTERIOR BITE PLANE

The lip bumper can be positioned at 3 levels of incisor crown

Effect of lip bumper

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