Message Boards
Today's Active Topics Today's Active Cases Browse Forum Categories My Recent Activity My Messages Private Groups My Marked Threads My Subscriptions
Today's Active Images Today's Active Polls Most Active Topics Global Townie Map Advanced Message Board Search Message Board Terms of Use

A Voice in the Arena: Bite Ramps Used for Anchorage by Dr. Chad Foster

Start Discussion More by this author (47)
Categories: Orthodontics;
A Voice in the Arena: Bite Ramps Used for Anchorage   

by Chad Foster, DDS, MS, editorial director

In previous columns I’ve discussed Class 2 and Class 3 bite ramps, and this month I’d like to present and discuss two unique cases where shaped/ramped bite turbos are being used to aid in anchorage.

The more I play with the shapes and applications of bite turbos, the more amazed I am by their simplicity and effectiveness. Their use comes with a learning curve, but the juice is worth the squeeze! (If you’d like an additional learning opportunity on the power of functional bite ramps, I’ll be speaking on this topic at the DynaFlex Pre-AAO Symposium in New Orleans on May 3. Join me!)

Case 1
The patient pictured below is missing an UL5. My goal is to close the space to avoid an implant and the challenge is to not compromise his upper midline in the process; that compromise would not make preventing the implant worth it in the big picture of aesthetic priorities.

A ramped bite turbo was placed on the UL4 to provide a mesial force on that tooth as the UL6 is leveled and that space is closed. Not shown in this picture are 3⁄16-inch heavy elastics that are being worn from the UL6 to the LL4 and the UL4 to LL3, both at night. These are an attempt to help with the same AP goal as described, and also to mitigate the intrusive effect on the UL4 as the archwire levels the UL6 (which shows mesial crown tip) early in treatment.

Having seen the effectiveness of Class 2-style bite ramps, I like to look for other ramp-style applications. I don’t know how this case will work out, but probably around the time of pano/repo I will reassess this setup and consider two palatal TADs and a Y bar to protract the upper left side if it looks like the upper midline compromise will be too much. It’s always good to have a solid backup plan when trying to get cute with mechanics!
A Voice in the Arena: Bite Ramps Used for Anchorage
A Voice in the Arena: Bite Ramps Used for Anchorage

Case 2
The case pictured below shows an important stage of treatment with inverted upper incisor brackets where a treatment goal is retraction of proclined upper incisors.

Class 2 bite ramps on the U4s (sloped down to contact distal of L4s) can serve many purposes. In this case, the patient had trauma to a lower incisor that was lost, and we have closed space in that arch. The upper incisors showed significant pretreatment protrusion. His upper incisor brackets are inverted. In this appointment, we have engaged the negative torque with a 16-by-25 stainless steel wire (first time negative torque activated). I prefer to time this appointment after pano-repo with interproximal reduction. Pairing the negative torque engagement with IPR favors relatively greater favorable lingual crown torque, as opposed to unfavorable facial root torque, in the U2–2.

Note the bite bumps that serve two purposes at this stage.
  • They disclude the teeth so the upper incisors are not contacting the lower incisors at all. In an inverted U2–2 bracket setup, if the upper incisors contact the lower incisors in a normal overjet relationship as the negative torque is “cooking,” a lesser amount of lingual crown torque will occur and a greater amount of facial root torque will occur. That would not be good!
  • The bite bumps in a Class 2 form contact the distal incline of the L4s. In this contact, the force of occlusion effectively anchors the U4s from moving mesially as the IPR (done U4–4) spaces close. Thus, a greater amount of retraction of the U3–3 will be achieved. I also will occasionally pair this with an U4–4 power-chain sling incisal to the U3–3 brackets when I think it is necessary.

    • A Voice in the Arena: Bite Ramps Used for Anchorage
    A Voice in the Arena: Bite Ramps Used for Anchorage

     
    Ramp up your knowledge of bite ramps!

    Click the following links to check out Dr. Chad Foster’s previous columns about Class 2 and Class 3 bite ramps.

More In Orthodontics
Game Changers: Remote Monitoring and Referral Marketing
Game Changers: Remote Monitoring and Referral Marketing
by Dr. Roger P. Levin
September 2025
Industry News
Industry News
March 2024
Phase I Treatment
Phase I Treatment
Dr. Daniel J. Grob
CE Credits: 1.5
Slop-py Work: Calculating Theoretical Torque Loss Utilizing Rectangular and Square-Shaped Archwires
Slop-py Work: Calculating Theoretical Torque Loss Utilizing...
Dr. Elizabeth R. Michalczyk, Dr. Noam Green and Dr. Alise Senderak
CE Credits: 1.5
Orthotown Magazine
September 2025
Orthotown Magazine September 2025 Read Current Issue Read Archived Issues
Sponsors
Townie® Poll
Do you have a dedicated insurance coordinator in your office?
  
Related Articles
Going It Alone
Going It Alone
by Dr. Donna Galante
December 2023
Poll: Aligners and Aesthetics
Poll: Aligners and Aesthetics
June 2025
Treat Now or Wait for Surgery?
Treat Now or Wait for Surgery?
September 2025
Site Menu
Message Boards Magazine Continuing Education Podcasts Blogs Classifieds News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Orthotown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450