Orthodontic treatment of deep bite in mixed dentition and/or early permanent dentition: What about stability? - A systematic review

Introduction > Deepbite is a vertical malocclusion found alone or in association with other types of sagittal and transverse disorders. With a high relapse tendency, deepbite is considered one of the most challenging malocclusions to treat. It is commonly found in mixed dentition with increased prevalence of 21.3% compared to 14.1% in temporary dentition, thus resulting on unfavourable consequences, preventing the mandible from its full growth potential. Therefore, this systematic review aims to investigate the efficiency of conducting an early correction of deepbite malocclusion in mixed and early permanent dentition on the long-term postretention outcomes.<br /> Material and methods > An electronic search extending from 2000 to July 2024, was performed on the following databases Medline via PubMed, Web of Science, Science Direct and Embase. The search was established on a well-defined research question following PICO principle: population, intervention, comparator and outcome. Search evaluation and the assessment of risk of bias were undertaken in each study following its type and design.<br /> Results > Six studies were included for qualitative analysis, with overall moderate RoB. Two studies treated deepbite in a single phase orthopaedic treatment with eruption guidance appliance in early mixed dentition; two studies orthodontically corrected deepbite at early permanent dentition using fixed multibracket appliance and two studies used a combination of orthopaedic treatment followed by orthodontic treatment targeting both subjects in early mixed and early permanent dentition. Conclusion > Patients treated in late mixed to early permanent dentition presented better efficacy and greater stability of outcomes than patients treated in the early mixed phase of dentition. More studies must be conducted to support and confirm the results of the included studies.