Lecture 7 Anterior & Posterior Crossbites (6 Per Page) (Compatibility Mode)

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Anterior and Posterior Crossbites

1 LECTURE 7 INGRID REED DDS, MS DEPARTMENT OF ORTHODONTICS & DENTOFACIAL ORTHOPEDICS
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Anterior Crossbite
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Anterior Crossbite - dental

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y Dental one or two teeth { Abnormal axial inclination { Retained primary tooth { Crowding { Usually Class I y Skeletal - Class III ANB <0 { Look at molar relationship { Take ceph y Pseudo Class III shift due to interferences when
end to end occlusion

{
Check bite in CR vs. CO for interference

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Anterior Cross bite - Dental

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Anterior Crossbite - Skeletal

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Anterior Crossbite - Dental

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Treatment Dental anterior crossbite

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y Popsicle stick y Removable appliance with finger spring y Fixed appliances y Possible extraction of adjacent j deciduous teeth
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Anterior Crossbite - Skeletal

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Tongue blade
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Hawley with finger spring

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y Assess space available y Alginate impression y Pour in yellow stone y Fabricate Hawley y with clasps p and finger g spring p g { Bend finger spring so it unwinds in the direction it was wound y Build up molars to clear occlusion y Deliver appliance y Activate spring every few weeks y Self retaining
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y Assess space available y Alginate impression y Pour in yellow stone y Fabricate Hawley y with clasps p and finger g spring p g { Bend finger spring so it unwinds in the direction it was wound y Build up molars to clear occlusion y Deliver appliance y Activate spring every few weeks y Self retaining
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Dental Anterior Crossbite

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Case JH
23 ANTERIOR CROSSBITE
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8 years 0 months
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Initial
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8 years 4 months
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Age 12 years
Anterior crossbite of lateral incisors

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y Maxillary laterals usually erupt to the lingual if
inadequate space
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Initial
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Retention of Anterior Crossbites

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Initial
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y Good overbite relationship y Should be self retaining y Tipping tooth forward vertical change in overbite
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Cleft Palate JB Start of Phase I

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End of phase I
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End of Phase 1
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Final Records
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Start of Phase II
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Final Records
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Start of Phase II
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Bilateral Cleft Palate

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Early permanent dentition treatment

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y Correct maxillary incisors { Rotations { Crossbite { Position y Expand E d maxilla ill y Alveolar bone graft
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Cleft palate treatment sequence

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TIME
2-4 weeks 12-18 months 7-8 years 7-9 years Adolescence Late adolescence Lip closure Palate closure
PROCEDURE
Alignment of maxillary incisors, expansion of maxilla, as preparation for alveolar graft Alveolar bone graft (before eruption of lateral incisor, if present, or canine) Comprehensive orthodontics Lip /nose revision Orthognathic surgery?
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Cleft palate orthodontic problems

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Unrepaired cleft - TG 1-24-03

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y Problems from repair not cleft itself { Lip repair constriction across anterior of maxilla anterior crossbite { Palate repair constriction laterally posterior crossbite y Problems from cleft { Maxillary incisors erupt rotated and in crossbite { Lateral incisor and/or canine in area of cleft missing or impacted { Cleft area doesnt have bone for eruption alveolar graft needed
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TG 1-24-03
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TG 10-25-08
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TG 1-24-03 TG 10-25-08
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TG 7-25-07
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TG 10-25-08
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8/25/2010
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Orthognathic surgery - cleft palate patients

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y Males > females y Growth return of anterior and/or lateral crossbites { Usually deficient maxillary growth { Normal mandibular growth
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Posterior Crossbites
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S K E L E T A L D E N T A L
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Posterior Crossbite
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y Posterior crossbite position of maxillary molars { Bilateral maxillary lingual crossbite { Unilateral maxillary lingual crossbite
Asymmetric maxillary arch Normal maxilla Asymmetric mandible
Unilateral mandibular buccal crossbite

Maxillary buccal crossbite (Brodie Bite)
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Why does this crossbite exist?

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y Bilateral maxillary palatal crossbite { Maxilla narrow - skeletal basis { Dental arch narrowed skeletal width correct
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Rapid Palatal Expander

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Treatment palatal expander

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Dental Posterior Crossbite

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Posterior Crossbites
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Oral habits disruptive to occlusion

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Effects of thumb sucking

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y Thumb sucking y Finger sucking y Tongue thrust y Nail biting g y Lip biting y Lip sucking
y Tongue lowered to accommodate thumb y Cheek pressure { Greatest at corners of mouth { More constriction at canines { V- shaped h d palate l { Lingual movement of maxillary molars { Mandibular molars unchanged { Anterior teeth and premaxilla can be moved
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Thumb (finger) sucking - phases

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Phase I
Birth to 3 years
Normal , especially associated with weaning. Usually self eliminated. 3-4 years: mild displacement of primary teeth; normal lip & cheek pressure will restore teeth to usual position if sucking stops Aft eruption After ti of f permanent ti incisors: i if sucking ki persists, i t stop t habit and start orthodontic treatment to correct tooth displacement. Constricted maxilla: least likely to correct spontaneously Thumb sucking may be a sign of psychological problems Talk to child Appliance to help child
Cheek
Phase II
3 to 6 or 7 years
Tongue
Phase III
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Thumb (finger sucking)

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Malocclusion due to sucking habit

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Lower incisors Upper incisors Maxillary M ill arch Interarch relation
Lingual displacement Labial displacement N Narrow
Anterior open bite
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Treatment
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Crib
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Reference
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Contemporary Orthodontics, 4th Edition

William R. Proffit Henry W. Fields Jr. David M M. Sarver
Pages: 68, 147147-149, 175175-176 ,224 ,224-226, 244244-248,437 248,437-443, 559559 -560, 622
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Lecture 7 Anterior & Posterior Crossbites (6 Per Page) (Compatibility Mode)

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Lecture 7 Anterior & Posterior Crossbites (6 Per Page) (Compatibility Mode)

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Formats disponibles

10/12/2011

Anterior and Posterior Crossbites

Anterior Crossbite - dental

end to end occlusion

Check bite in CR vs. CO for interference

Anterior Cross bite - Dental

Anterior Crossbite - Skeletal

Anterior Crossbite - Dental

Treatment Dental anterior crossbite

Anterior Crossbite - Skeletal

Hawley with finger spring

Hawley with finger spring

Hawley with finger spring

Dental Anterior Crossbite

Anterior crossbite of lateral incisors

y Maxillary laterals usually erupt to the lingual if

Retention of Anterior Crossbites

Cleft Palate JB Start of Phase I

Bilateral Cleft Palate

Early permanent dentition treatment

Cleft palate treatment sequence

Cleft palate orthodontic problems

Unrepaired cleft - TG 1-24-03

Orthognathic surgery - cleft palate patients

Asymmetric maxillary arch Normal maxilla Asymmetric mandible

Unilateral mandibular buccal crossbite

Maxillary buccal crossbite (Brodie Bite)

Why does this crossbite exist?

Rapid Palatal Expander

Treatment palatal expander

Dental Posterior Crossbite

Oral habits disruptive to occlusion

Effects of thumb sucking

Thumb (finger) sucking - phases

Thumb (finger sucking)

Malocclusion due to sucking habit

Lower incisors Upper incisors Maxillary M ill arch Interarch relation

Lingual displacement Labial displacement N Narrow

Anterior open bite

Contemporary Orthodontics, 4th Edition

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