Combination in Deep-Bite Cases: The Equiplan-Quad Helix

The Equiplan-Quad Helix
Combination in Deep-Bite Cases

JOSÉ MARCIO SALGADO PATO, DDS
SIMONE V. MACUCO DE SABOIA, DDS
BRUNO JOSÉ MARTINS PATO, DDS
JOSÉ MARCIO MARTINS PATO, DDS
T his article presents a treatment method and

fixed appliance designed to correct dental
deep bite in patients of any age, or skeletal deep
bite in growing patients. The appliance was
developed by Dr. J.M.S. Pato in 1992 by attach-
ing a Planas Equiplan1 to a Quad Helix* or a
transpalatal bar (Fig. 1).
The palatal expander is inserted into the lin-
gual tubes of the first molar bands or welded
directly to the molar bands. The Planas Equiplan
is attached to the anterior arms with acrylic or
directly to the anterior helices of the Quad Helix. Fig. 2 Case 1. 10-year-old male Class II patient
Although the same bite-opening effect can be with deep bite before treatment.
obtained by using an acrylic or metal biteplane,
such as the Bite Turbo,** or with lingual appli-
ances, we use the Equiplan because of our long
experience in using it with Bimler functional
appliances.
The Equiplan-Quad Helix combination can
expand the palate and open the bite at the same
time by intruding the anterior teeth, extruding the
posterior teeth, and unblocking the occlusal
plane. Thus, it can help resolve TMJ problems
*RMO Inc., P.O. Box 17085, Denver, CO 80217.
**Ormco/“A” Company, 1717 W. Collins Ave., Orange, CA 92867.
Fig. 3 Case 1. Fixed appliances used with Equi-
plan-Quad Helix combination.
Fig. 1 Planas Equiplan-Quad Helix combination. Fig. 4 Case 1. After four years of treatment.
434 © 2002 JCO, Inc. JCO/AUGUST 2002

From the Pato Orthodontic Team, Rua Borges Lagoa, 280, Vila Cle-
mentino, São Paulo, SP, CEP 04038-000, Brazil. Contact Dr. J.M.S.
Pato at pato@patoortodontia.com.br.
Dr. J.M.S. Pato
and shorten treatment time. In Class II cases,

with the occlusion unlocked, the mandible can
easily be advanced using a mandibular propulsor
or Class II elastics.
Case 1
A 10-year-old male presented with the chief
complaints of spaces between the teeth and lack
of occlusal balance. Clinical evaluation showed a
Class II malocclusion with a deep bite, midline
deviation, and maxillary atresia (Fig. 2).
Fig. 5 Case 2. 27-year-old female with deep bite
Orthodontic treatment began with an ortho- before treatment.
pedic appliance, followed by Bioprogressive
therapy. The appliance described above was used
for six months to open the bite (Fig. 3). Treat-
ment was completed at age 14 (Fig. 4).
Case 2
A 27-year-old female presented with the
chief complaint of a lack of occlusal balance
(Fig. 5).
The Equiplan-Quad Helix combination was
used for eight months to resolve the deep bite
(Fig. 6). Complete orthodontic treatment lasted
two years (Fig. 7).
Fig. 6 Case 2. Fixed appliance used with Equiplan-
Quad Helix combination.
Discussion
Special attention needs to be paid in a deep-
bite case to the patient’s developmental stage and
to a differential diagnosis of the skeletal and den-
tal components2,3. As Moyers pointed out, a deep
bite should not be considered a separate entity,
but a part of the overall malocclusion.4 In
cephalometric analysis of deep bite, the palatal,
mandibular, and occlusal planes tend to be paral-
lel, with a deficient gonial angle.4 Skeletal deep
bite is further characterized by excessive strength
of the anterior oral muscles, a horizontal growth
pattern, deficient facial height, an overly long Fig. 7 Case 2. After two years of treatment.
VOLUME XXXVI NUMBER 8 435

The Equiplan-Quad Helix Combination in Deep-Bite Cases
posterior cranial base, and a brachycephalic orthodontic movements can be performed with-
mandible.5 out interference. Unlike many appliances used to
When dealing with deep bite in growing open deep bites, it cannot be removed by the
children, the ideal growth pattern should first be patient. Thus, the time required to correct the
stimulated with functional orthopedic appliances deep bite can be reduced to an average of only
as appropriate to each patient, as was done in about six months.
Case 1.
REFERENCES
Conclusion
1. Planas, P.: Equiplan, in Genesis de la Rehabilitación Neuro-
The Equiplan-Quad Helix appliance can be Oclusal, Impresora San Luis, Mexico, 1972, pp. 120-133.
used successfully in patients of any age with den- 2. Popovich, F.: Cephalometric evaluation of vertical overbite in
young adults, J. Can. Dent. Assoc. 21:209, 1955.
tal deep bite, in growing patients with skeletal 3. Rakosi, T.; Jonas, I.; and Graber, T.M.: Ortodontia e Ortopedia
deep bite, and when treating Class II malocclu- Facial: Diagnóstico, Editora Artmed, São Paulo, Brazil, 1999.
sion with deep bite. Its main advantage is that the 4. Moyers, R.E.: Ortodontia, 4th ed., Guanabara Koogan, Rio de
Janeiro, Brazil, 1991.
fixed Quad Helix expands the palate at the same 5. Langlade, M.: Diagnóstico Ortodôntico, Editora Santos, São
time that the occlusal plane is unblocked, so that Paulo, Brazil, 1993.
436 JCO/AUGUST 2002

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The Equiplan-Quad Helix

Combination in Deep-Bite Cases

T his article presents a treatment method and

434 © 2002 JCO, Inc. JCO/AUGUST 2002

and shorten treatment time. In Class II cases,

VOLUME XXXVI NUMBER 8 435

436 JCO/AUGUST 2002

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