Inclined Bite Plates – Fixed and Removable Retainers for Class II

Introduction

• Dr. Amanda addresses a common orthodontic question regarding inclined bite plates versus standard anterior bite plates, applicable in both fixed and removable retainers.
• Focus: their role in correcting deep bites and managing Class II cases, along with when they may or may not be effective.

Understanding Bite Plates

• Types of bite plates:
  • Inclined bite plates (upper or lower).
  • Removable bite plates.
  • Fixed anterior bite plates.
• Literature on this topic is limited, though some orthodontic research provides general insights into their effectiveness.
• Inclined designs add a ramp-like element, but the difference from standard plates is relatively minor.

Effectiveness and Limitations

• Inclined bite plates may not make a significant difference compared to standard anterior bite plates.
• They generally do not cause harm, so can be considered as an option.
• Effectiveness depends heavily on the patient’s growth stage and treatment goals.

Patient Age and Growth Considerations

• Older teens nearing the end of puberty:
  • If significant overjet (e.g., 4mm) remains, inclined plates will not stimulate jaw growth.
  • Options at this stage are limited to camouflage treatments or jaw surgery for true correction.
• Younger patients’ post-phase one:
  • With growth potential remaining, inclined bite plates may be useful if compliance is good.
  • They offer a non-invasive adjunct, though not a growth modification tool.

Alternatives and Enhancements

• Rickonator appliance:
  • Functions as an incline bite ramp with a built-in ledge.
  • More effective than a plain incline because it gives a tactile “resting point” for lower teeth.
  • Encourages better compliance and functionality.
• Dr. Amanda suggests these can be more reliable than standard inclined bite plates.

Conclusion

• Inclined bite plates are a low-risk option but have limited effectiveness in jaw growth correction.
• Best suited for younger patients with growth remaining; less effective in older teens.
• Alternatives like the Rickonator may provide better control and outcomes.
• Ultimately, clinicians should consider patient age, growth stage, and treatment goals when selecting retainer designs.