How and when to use Invisalign clear aligners bite ramps? Should you use bite ramps every time you treat a deep bite case? If you receive a ClinCheck setup or a ClinCheck treatment plan including bite ramps, should you always leave them there? If not, when should you remove them and when should you keep them? The answers in this C.L.E.A.R. Tip where Dr. Stephane Reinhardt, Director of Education Program for The C.L.E.A.R. Institute tells you what you need to know about bite ramps, when to use them, and why and when to avoid them. If you like these videos, subscribe to the channel, click the bell to be notified every time we upload a new video (at least once a week) and give us the thumbs up 👍👍👍 The C.L.E.A.R. Institute provides ONLINE and LIVE in-person courses if you want to know more about clear aligners and educate yourself, learn, understand, apply, use, and master them. All our courses and programs: ✅ FREE course: Are clear aligners for you? (1 CE credit) Introduction to clear aligners: is it for you? ✅ LIVE in-person courses Live in-person ✅ Online courses Online courses ✅ Online Master Of CLEAR Aligner Programs (M.O.C.A.) Learning programs ✅ MOCA 101 and 10 hours of private coaching (Limited to 25 dentists) M.O.C.A. 101 + Private coaching ✅ Subscribe to our YouTube channel ✅ All our links ✅ “Let’s be CLEAR” – Blog: ✅ Website ✅ Need some help with your cases? ✅ Contact us here: ✅ Read the blog version: 👉 The C.L.E.A.R. Institute is an AGD PACE-approved provider. Timestamps 0:00 Introduction 0:48 What are bite ramps? 1:34 The idea behind the bite ramps 1 2:25 The type of patient it is made for 2:43 The idea behind bite ramps 2 2:57 The problem is… 3:19 Let’s look at a case 4:40 In the prescription 5:06 How bite ramps look 6:36 Be careful of one thing 7:26 Let’s think a little bit 8:30 Force with bite ramp 9:06 Staging your treatment 9:45 My suggestion for Align: the Reinhardt bite-ramp! 10:09 The difference between having a bite ramp or not 10:34 Think like plastic 10:51 Dr. Gerry Samson’s trick 11:36 Conclusion 12:00 Subscribe 12:20 Visit and get your rebate The C.L.E.A.R. Institute’s mission is to help dentists, and team members integrate efficiently and successfully clear aligners in their daily practice. We want you to be as comfortable talking about clear aligners to your patient as you are about any type of regular restoration. The vision of The C.L.E.A.R. Institute is that clear aligners treatment become as common as any type of regular dentistry performed in a dental office. We see it as part of any comprehensive treatment proposed to your patients. C.L.E.A.R. stands for Clinical Lecture Education Aligner and Restoration. Whether it is from live face-to-face courses, our digital platform, or this YouTube Channel, our goal is to bring you the information and education you need to succeed with clear aligners. This is why even if we focus on clear aligners, we also cover subjects such as Communication, Finance, Protocols, Roles of everyone, and Restoration. In today’s dentistry, everything is integrated. We want you to maintain that passion and this desire to learn and constantly improve. Become a better dentist. And better team members. For us, it’s an honor and a privilege to be able to share our passion and knowledge with our peers. We never finish learning: education is never a waste of time! Follow us on our different platforms: The C.L.E.A.R. Institute is where dentists and team members “Make the MOVE”! Who said dentistry and education should be boring❓❗❗❗ The C.L.E.A.R. Institute devotes all its efforts to retaining the services of high-quality and recognized educators in our field of activities. Our Institute presents its clientele with original, objective, and high-quality educational content. All such contents are the exclusive property of The C.L.E.A.R. Institute and have been developed independently and following the state of the art. The statements, views, and opinions expressed in this program and related course materials are those of the speaker. Align Technology Inc, makers of Invisalign and owners of the ClinCheck® software, may not endorse such statements, views, and opinions. Invisalign ® and ClinCheck ® are trademarks or registered trademarks of Align Technology, Inc. in the United States and other countries. #theclearinstitute #biteramp #invisalign

26 Replies to “How and when to use Invisalign clear aligners bite ramps?”

  1. Nicely done. Very “CLEAR” and clinically useful information. With compliments……..

    1. Coming from the Gaffer himself, what more could we ask for? And thank you for all the tips and tricks coming from you that changes the way we practice orthodontics. For all of you out there wanting excellent non-biaised orthodontic education, visit Dr. Samson’s (g)nathos website at

  2. I love your teaching style with some casual humor thrown in but you still seem very knowledgeable and passionate

    1. Dear Joey Arthur Zooberry, we are glad you enjoyed watching our video. Thank you so much for your comment; it describes exactly what we want to do. Education Entertainment. Who said dentistry was boring 😉 Stay tuned for more coming up soon!

  3. I still feel like I know nothing. I don’t see how putting ramps behind my 2 front teeth which already completely cover my bottom teeth with a 100% overbite, will not push them out even further. Because it feels like I’m pushing my top 2 teeth out, and I need my bottom teeth to come out!

    1. Thank you for your comment Dot Donahue. It may not be something that applies to your case. Hard to say. We recommend consulting a dentist or orthodontist with experience in clear aligner treatments. It may be tricky if you feel you are pushing on your 2 top teeth and you need your bottom teeth to come out even more. This would increase the force on the top teeth… Unless they need to move out too! Consulting with your dentist/orthodontist should give you all the information you need to take a good decision.

  4. Just started with bite ramps on my invisalign last week. Should my bottom teeth be pressing under these ramps when i’m relaxing, or should I relax my jaw like it normally is, without any lower and upper teeth touching? My mouth seems to want to bite under the ramps right now. Should I?

    1. We advise you ask your tresting dentist/orthodontist for that question. In general, bite ramps are there to disocclude posterior teeth but also could play a role in anterior intrusion. No studies show that yet, but it was thought that way. We usually say to patients to stay relax and not think about it, but again, your dentist/orthodontist will be the best one to explain to you what is the purpose of having the bite ramps in your case. Thank you for your question Damon!

    2. @The CLEAR Institute Ok I asked my ortho and this is their response….

      “Just bite normal. You don’t have to try to always have contact with them. Just relax your jaw like you normally would. If this does not make sense or you have further questions please reach out to us again. Have a great day Damon!”

  5. What about using the bite ramps from 13 to 23 for upper and lower anterior intrusion? Will them cause a posterior opened bite?

    1. Good question! First, bite ramps can be used from 12 to 22 OR on the cuspids. Second, to produce intrusion the force would need to be constant. Bite ramps does not mean the patients will constantly bite on them and apply a constant force necessary to intrude the teeth.Third, in a situation where you would have anterior intrusion, you would have less chance of causing posterior open bites. A lot of time we see POB happening when the intrusion of the anterior teeth does not happen. We hope this helps. Thank you for your question.

  6. May I ask what kind of the plastic at 9.50 that you would suggest us to use ? Thank you for the useful clips, I am really appreciated.

    1. This is a suggestion we make to aligner manifacturer 🙂 If you would like to mimic this, you could fill the bite ramps with composite so that the surface of the composite would apply a force on the tooth, therefore eliminating the void. We hope for this new feature we are talking about in the future! Maybe a wish for 2022 🙂

    1. That is an excellent question *kristine ten* ! It’s always possible to do that, and in some cases a good idea (brachy patients with BIG masseters). As long as it’s comfortable for the patient, helps his/her condition and maintains the teeth in place. Some prefer that option to wearing an occlusal splint.

    1. It really depends on the technique you are using. Passive extrusion, active extrusion… Aligners only, aligners and elastics, aligners, elastics and TADs? Vertical movements are still the most challenging to achieve with clear aligners. Remember that 1mm of posterior extrusion will give you 2-3 mm of anterior bite opening. That should always be considered when planning your treatment,

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