Disclaimer: Please note that not all features are available in all markets. Contact your local Straumann or ClearCorrect representative to find out what is available in your area.

For information about bite ramps, refer to the following:

• General Information About Bite Ramps
  • Types of Bite Ramps
• ClearCorrect Aligners and Bite Ramps
• Anterior Bite Ramps
  • Tips for Anterior Bite Ramps
  • Protocols and Requesting Anterior Bite Ramps
• Posterior Bite Ramps
  • Protocols and Requesting Posterior Bite Ramps

General Information About Bite Ramps

Bite Ramps are thermoformed protrusions in the aligner that hold the arches out of occlusion and can be located in either the anterior or posterior region.

• Bite ramps prevent the opposing arch from interfering with tooth movements needed to treat different clinical conditions such as deep bites, crossbites and open bites.
• Anterior bite ramps in clear aligners can appear similar to engagers, however bite ramps are not intended to be filled with composite.
• Posterior bite ramps with ClearCorrect are located on the occlusal surface of the tooth and appear as 3 consecutive "coin shapes" that are thermoformed into the aligner. These are not intended to be filled with composite either.

Bite Ramps create premature contact in the anterior or posterior region, which then takes the teeth out of occlusion helping to remove unwanted bite forces to allow for certain tooth movements and correction to take place.

Anterior Bite Ramps	Posterior Bite Ramps

Types of Bite Ramps

There are two classifications for bite ramps:

Types of bite ramps in clear aligners:

	Anterior Bite Ramps Placed lingually in the upper anterior region on the central incisors, lateral incisors, canines or a combination of these. They are commonly used to treat deep overbites/deep bites.
	Posterior Bite Ramps Posterior bite ramps are placed on the occlusal surface of the premolars or molars, in either the upper, lower or both arches. They are commonly used to treat both anterior and posterior crossbites and open bites.

Types of bite ramps in general orthodontic treatment:

ClearCorrect Aligners and Bite Ramps

ClearCorrect currently offers non-bonded bite ramps for both the anterior and posterior regions. 

ClearCorrect's Anterior Bite Ramps

The technician will determine the size and depth of each anterior bite ramp based on the size of the tooth and the contact desired between the lower incisors and the bite ramp, or you can make a custom request in your prescription form in the Doctor Portal, in the Comments Panel of ClearPilot, or by using 3D Controls to modify the arrangement provided in the Treatment Setup. 

• Prescribe the ideal anterior bite ramp configuration for your patient in the Doctor Portal:
  • Centrals only
  • Centrals and lateral incisors
  • Canines only
  • Customized
• Review the treatment plan and approve it in ClearPilot
• Receive your aligners for your patient to start wearing according to your treatment plan

ClearCorrect's Posterior Bite Ramps

The technician will place posterior bite ramps on the lower first and second molars by default. You can make a custom request to have posterior bite ramps placed on the premolars and/or upper arch.

• Posterior bite ramps have two available prominences:
  • 1.5 mm for second molars
  • 2.0 mm for first molars or premolars
• Angulation is a standard 90º angle with the occlusal plane
• Posterior bite ramps can be started on any step of treatment
• Review the treatment plan and approve it in ClearPilot
• Received your aligners for your patient to start wearing according to your treatment plan

Anterior Bite Ramps

Anterior bite ramps are most commonly used to treat patients that present with deep bites. They can also be used to level the Curve of Spee with mandibular incisor intrusion or to treat patients with large masseters who frequently bite down and put a significant amount of pressure on the molars.

Deep Bite Anterior bite ramps can be used to open the patient's bite by either intruding the anterior teeth, extruding the posterior teeth or a combination of both.
Curve of Spee Correction Anterior bite ramps can be used to address the Curve of Spee which can help correct deep overbites. By proclining the lower incisors to obtain a relative intrusion, and alternating canine and incisor (actual) intrusion, a higher and more specific force can be exerted on the canines and incisors.

Tips for Anterior Bite Ramps

We have a few tips to offer regarding anterior bite ramps:

• For cases with large overjet, bite ramps should be placed on the canines and can be used with Class II elastics.
• For cases needing proclination of the upper incisors, utilize the benefits of the plastic coverage of the aligner and delay the use of bite ramps until the incisors are in a better position.
• When you need extrusion of posterior teeth, engagers can be added to the posterior teeth to achieve hard occlusal contacts. Use the “Occlusal” tool in ClearPilot™ to check the contacts.

Protocols and Requesting Anterior Bite Ramps 

ClearCorrect's default protocol for anterior bite ramps:

• Anterior bite ramps will be placed lingually in the upper 4 anterior teeth (2x2 configuration)

• If anterior bite ramps don’t contact the opposing arch, the bite ramps will be placed only on the canines

• Depths available in 3 mm and 5 mm, technician will select the depth that provides the better contact

• No Arch Correction Simulation (ACS) will be applied unless specifically requested by the clinician

• Anterior bite ramps can be requested on new cases, or existing cases through a revision (additional charges may apply).

Requesting anterior bite ramps:

Anterior bite ramps can be requested in the prescription form. Depending on the patient's dental condition (crossbite or deep bite), you will be prompted with an option to indicate if you will want anterior bite ramps added to the treatment.

It is important to also include any other details regarding the request for anterior bite ramps in the "Additional information" section of the case submission form. 

To make a custom request for anterior bite ramps, you'll need to communicate the following specifics in the "Additional information" section of the case submission form:

• The size of anterior bite ramps
  • 3 mm
  • 5 mm
• The position of the anterior bite ramps
  • Incisors (Central & Lateral) (2x2)
  • Incisors and Canines (3x3)
  • Canines only

Posterior Bite Ramps

Posterior bite ramps can be used in a variety of cases where there is a need for increasing the available space and/or to improve intrusive forces in the posterior region. The two primary uses are for crossbites and/or open bites.

Crossbite A posterior bite ramp can be used to move the anterior teeth out of occlusion to assist with the correction of an anterior crossbite with a deep overbite.
Open Bite Posterior bite ramps can be used to intrude the molars, creating a backward mandibular rotation thus reducing the open bite.

Protocols and Requesting Posterior Bite Ramps 

ClearCorrect's default protocol for posterior bite ramps:

• Posterior bite ramps will be placed occlusally on the lower first and second molars

• Prominences available are 1.5 mm and 2 mm. 1.5 mm will be used on second molars while 2 mm will be used for first molars and premolars

• No Arch Correction Simulation (ACS) will be applied unless specifically requested by the clinician

• Posterior bite ramps can be requested on new or existing cases by requesting a revision (Note that additional charges may apply)

Requesting posterior bite ramps:

Posterior bite ramps will only be added upon request from the clinician. 

1. Sign into the Doctor Portal
2. Create an order for the case and proceed through to Step 4
3. On Step 4 "Additional Instructions" add the request for posterior bite ramps to be added to the treatment plan
4. Complete the rest of the order and click "Submit"

It is important to also include any other details regarding the request for posterior bite ramps in the "Additional information" section of the case submission form. 

To make a custom request for posterior bite ramps, you'll need to communicate the specifics of the custom request in the "Additional information" section of the case submission form.

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