Protruded teeth, or increased overjet, occur when the upper front teeth extend too far forward in relation to the lower front teeth. This condition can affect function, aesthetics, and self-confidence. Treatment strategies depend on whether the patient is still growing or has completed their growth, and they range from growth modification techniques to advanced orthodontic and surgical solutions.
While all options aim to achieve proper occlusion, the choice of treatment can influence facial aesthetics differently, emphasizing the importance of individualized treatment planning.
In growing patients, the focus is often on modifying or utilizing the patient’s natural growth potential to correct the malocclusion. Key options include:
Functional appliances, such as the Twin Block or Herbst appliance, aim to modify jaw growth and correct skeletal discrepancies. They encourage forward growth of the lower jaw and guide the teeth into proper alignment. While these devices have some skeletal effects, much of their impact is dental.
Timing is critical for success, as these appliances are most effective during the pubertal growth spurt.
Modern clear aligners, such as Invisalign with mandibular advancement features, combine the benefits of aligner therapy with lower jaw advancement. These aligners are discreet and effective for mild to moderate cases of increased overjet, especially in patients who prefer an aesthetic solution.
The Herbst appliance, when combined with customized lingual braces, provides an innovative and effective treatment option for growing patients. The Herbst appliance works by guiding the lower jaw forward, while lingual braces (placed on the inside surfaces of the teeth) discreetly align the teeth. This combination offers the dual benefits of skeletal correction and precise dental alignment, making it particularly appealing for patients concerned about aesthetics during treatment.
For non-growing patients, treatment focuses on addressing the dental and skeletal imbalance through orthodontic appliances, auxiliary tools, and sometimes surgical intervention. Options include:
Elastic bands work with fixed braces to adjust the bite by moving the upper and lower teeth into alignment. This approach is straightforward and relies on patient compliance to wear the bands consistently.
The Carriere Motion appliance is a pre-braces treatment that uses elastics to move upper molars backward and improve jaw alignment. It’s particularly useful for moderate Class II cases and helps prepare the bite before transitioning to braces or aligners.
Fixed bite correctors, such as the Forsus appliance or MARA (Mandibular Anterior Repositioning Appliance), are semi-permanent devices used with braces to reposition the lower jaw forward. They are effective for patients who may struggle with elastic compliance.
For non-growing patients, the Herbst appliance can also be combined with customized lingual braces. While the skeletal changes are minimal in adults, the Herbst appliance helps reposition the bite, while the lingual braces align the teeth discreetly. This combination is ideal for patients seeking a functional and aesthetic solution for increased overjet.
In severe cases, selective removal of teeth can create the necessary space to align the remaining teeth and correct the overjet. While effective, extractions require careful planning to ensure that the facial profile remains balanced.
Mini-screw-assisted appliances, such as TAD-supported distalizers, allow orthodontists to move upper molars backwards without relying on patient compliance. This technique is effective for creating space and reducing overjet while minimizing the need for extractions.
In cases of severe skeletal discrepancies, jaw surgery may be required. This involves repositioning the jaws to achieve proper alignment and improve facial aesthetics. Jaw surgery is typically reserved for patients with significant skeletal issues that cannot be resolved orthodontically alone.
While all these treatment options aim to correct the bite and achieve proper occlusion, they may result in different facial and aesthetic outcomes. For instance:
Choosing the right treatment requires careful consideration of factors such as:
Increased overjet is a treatable condition with multiple orthodontic solutions tailored to both growing and non-growing patients. Combining appliances like the Herbst with cutting-edge techniques, such as customized lingual braces, offers functional and aesthetic benefits.
Each treatment plan must be personalized to ensure not only a functional bite but also harmonious facial aesthetics, delivering the best possible outcome for every patient. To determine the most suitable option for your specific needs, consult an experienced orthodontist who can guide you through the process.
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I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
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