Implants · patient case question
In a Class II division 2 malocclusion, the curve of Spee is typically:
Patient case: Implants, spaces and a lost tooth
demo: 48-year-old male
chief: Wishes to replace a missing mandibular first molar with an implant.
history: Healthy non-smoker. He also has a Class II division 2 incisor relationship.
meds: None.
findings: CBCT shows 13 mm of bone height above the inferior alveolar canal at the proposed site. The mandibular arch shows a deep overbite. A separate panoramic film taken for a different patient is used to review counting of missing teeth.
Show answer and explanation
Correct answer: B. Steep, or exaggerated
- A. A flat curve is associated with an open bite tendency, the opposite pattern.
- B. Correct. Class II division 2 features retroclined maxillary central incisors and a deep overbite, and the deep bite is accompanied by an exaggerated curve of Spee as the mandibular posterior teeth overerupt. Levelling that curve is a defined objective of orthodontic treatment and requires arch length that must be accounted for in planning.
- C. A reversed curve of Spee is found in some skeletal Class III and open bite presentations, and is also created deliberately by a reverse curve archwire used to level a deep bite.
- D. The curve of Spee is closely tied to the vertical relationship, so it is very much affected here.