Illusion Aligners

Overview

For every PEOT case submission, the following bite records are mandatory:

A – Habitual Bite

A Habitual Bite is the way a patient naturally closes their teeth together out of habit.

B – Forward Bite

A Forward Bite refers to a mandibular position in which the lower jaw is carried forward in relation to the upper jaw, beyond its normal centric relation or habitual position.

C – Midline Documentation – to be recorded in case of deviation

The facial midline is an invisible line that divides the face into two symmetrical halves passing through facial landmarks, while the dental midline is the line between the central incisors of either arch.

If midlines differ, record both habitual and forward positions with and without midline coincidence.

Protocols for Recording a Bite:

A – Habitual Bite

Step 1:

Ensure the patient is relaxed and seated upright with the head in a natural position.

Step 2:

Soften the recording material, place it between the teeth, and have the patient gently close into their habitual bite without any manipulation. Hold the position until the material is set.

Step 3:

Once the material is set, remove the record carefully and check for accuracy. Label the record and send the bite registration along with dental scans and other necessary records to the lab for appliance fabrication.

B – Forward Bite

Step 1: Determine Maximum Comfortable Protrusion

Instruct the patient to move the mandible forward as far as possible without strain.
This represents the maximum protrusive position, not to be used directly for registration (to avoid over-advancement or “fishing”).

Step 2: Calculate Therapeutic Advancement

Reduce maximum protrusion by approximately 30% to find the therapeutic position.
In most cases, this will be edge-to-edge or up to 1 mm short of that position.

Step 3: Gain Vertical Opening

Maintain 1 mm interincisal vertical opening and record the bite (no opening needed in open-bite cases).

Note:
1. For severe overjet cases, the maximum protrusion may just reach edge-to-edge, reduce the advancement by 30%, and proceed with registering the bite.
2. For open bite cases, no vertical opening is needed (minimal opening), only horizontal advancement.

C – Midline Documentation

Where possible, dental midlines should coincide at advancement. However, if the midline shift is dental (not skeletal), register at habitual midline to avoid introducing facial asymmetry.
If skeletal shift, document and consider registering with best achievable midline alignment or as dictated by clinical plan.
Always document and photograph facial landmarks vs. dental midlines in all positions.

In case of any doubt, record both the habitual and the best achievable midline alignment.

For Each Case, Record in the Clinician Notes

Maximum protrusion achieved.
Amount used for registration (70% of maximum) or edge to edge whichever is smaller with 1 mm of interincisal opening.
Midline relationship and type (dental/skeletal).
Clearly label scans as habitual bite and advanced bite; include alternate midline registration if applicable.
Details and photographs of facial landmarks vs. dental midlines in all positions.
Any limitations, discomfort, or special considerations.

How to Record a Bite

Overview

A – Habitual Bite

B – Forward Bite

C – Midline Documentation – to be recorded in case of deviation

Protocols for Recording a Bite:

A – Habitual Bite

Step 1:

Step 2:

Step 3:

B – Forward Bite

Step 1: Determine Maximum Comfortable Protrusion

Step 2: Calculate Therapeutic Advancement

Step 3: Gain Vertical Opening

C – Midline Documentation

For Each Case, Record in the Clinician Notes

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