Bite Ramps Overview – CandidPro

Overview of Bite Ramps

Bite ramps (sometimes called Bite Blocks or Turbos) are specially designed, thermoformed features within the aligner that maintain a separation between the dental arches, thus preventing them from occluding. These can be positioned either in the front (anterior) or back (posterior) sections of the mouth. The primary function of bite ramps is to prevent the opposing arch from disrupting the necessary tooth movements required to address various dental conditions such as deep bites, crossbites, and open bites.

Anterior bite ramps are found on the lingual side of the upper front teeth. While they may resemble attachments in clear aligners, it's important to note that bite ramps should not be filled with composite material.

Posterior bite ramps appear on the chewing surfaces of the teeth, characterized by "box-shaped" forms that are integrated into the aligner. Similar to anterior ramps, these are also not meant to be filled with composite.

By creating early contact either in the front or back of the mouth, bite ramps help disengage the teeth from normal biting positions. This action relieves undesirable biting forces, facilitating specific tooth movements and corrections.

Type of Bite Ramps

CandidPro offers non-bonded bite ramps for both anterior and posterior regions.

Application of Anterior Bite Ramps

Anterior bite ramps are primarily employed to manage patients with deep bites. Additionally, they are useful in leveling the Curve of Spee through the intrusion of mandibular incisors, or in cases where patients with robust masseters exert excessive pressure on their molars by frequently clenching.

Tips for Using Anterior Bite Ramps

In cases with a significant overjet, it's advisable to place bite ramps on the canines, combined with the use of Class II elastics.
When aiming for the proclination of upper incisors, it's beneficial to utilize the full coverage of the aligner plastic before introducing bite ramps, ensuring that the incisors are better positioned first.
To achieve the extrusion of posterior teeth, consider adding attachments to these teeth to establish firm occlusal contacts.

Protocols for Anterior Bite Ramps with CandidPro

The standard setup involves placing bite ramps lingually on the anterior teeth.
If the ramps do not contact the opposing arch, they will be positioned only on the canines.
Depths will be chosen by the technician based on which provides optimal contact.
Prominence Sizes: Typical prominence size starts from 2mm. The choice of size depends on the specific requirements of the treatment.

Requesting Anterior Bite Ramps

Anterior bite ramps can be requested for new or existing cases via a revision, using the intake form available. The form allows you to specify the need for bite ramps based on the dental condition being addressed, such as a crossbite or deep bite.

Applications of Posterior Bite Ramps

Posterior bite ramps are particularly useful in scenarios where increasing space and enhancing intrusive forces in the posterior region are required. Their main applications include the treatment of crossbites and open bites.

Protocols for Posterior Bite Ramps with CandidPro

Placement: The placement of Posterior bite ramps is typically on the molars but customized per doctor's request.
Prominence Sizes: Typical prominence size starts from 2mm. The choice of size depends on the specific requirements of the treatment.

Requesting Posterior Bite Ramps

Posterior bite ramps can be requested for both new and ongoing cases through a revision process.
During the case submission, you have the opportunity to specify the need for posterior bite ramps, ensuring they are included as part of the initial treatment setup or added later as required.

Bite Ramps - FAQs

Suitability of Bite Ramps

Bite ramps are not suitable for every patient. The decision to use bite ramps involves a thorough analysis of the patient's case by the doctor and a CandidPro Orthodontist to determine if they are necessary.

Filling Bite Ramps with Resin

It is important not to fill the bite ramp areas with resin. These ramps are specifically designed to function effectively without the addition of resin. Dental staff should be cautious not to mistake them for attachments, as their appearance is quite similar.

Communicating About Bite Ramps to Patients

Patients should be informed that bite ramps might alter the feeling of their bite both while wearing the aligners and shortly after removing them. Any discomfort should be reported to their treating clinician immediately. Patients should also be made aware that:

Anterior bite ramps may contact the tongue, which might require some time to get accustomed to.
Posterior bite ramps are located on the chewing surfaces of the teeth, leading to an initial increase in the space between the teeth. This space is temporary and will close by the end of the treatment once the ramps are removed.

Deep Bite Management: Anterior bite ramps facilitate the opening of the bite by either intruding the front teeth, extruding the back teeth, or using a combination of both techniques.
Curve of Spee Correction: Anterior Bite ramps are instrumental in correcting deep overbites by intruding the lower incisors. Proclination of the lower incisors will result in relative intrusion. Some absolute intrusion of all lower anterior teeth may occur as well. Anterior bite ramps also facilitate the potential extrusion of posterior teeth, contributing to Curve of Spee correction.

Crossbite: Posterior bite ramps can be employed to disocclude the anterior teeth, aiding in the correction of an anterior crossbite coupled with a deep overbite. Or single tooth posterior crossbite correction.
Open Bite: Ramps are effective in intruding the molars, which can lead to a auto-rotation of the mandible, thereby reducing the severity of an anterior open bite.