Anterior Crossbite Research Articles

Management of Anterior Single Tooth Crossbite Using Removable Posterior Teeth Bite Plane Along With Z-Spring: A Case Report

Anterior crossbite is defined as a malocclusion characterized by the anterior maxillary teeth lingual position compared to mandibular anterior teeth. The prevalence of anterior crossbite that has been reported in the mixed dentition stage varies between 1.6 percent and 7.9 percent. Anterior crossbite cases should be treated by emergency intervention in the early period to prevent the consequences of malaligned teeth and their effect on the normal overall growth and development of the child. Patient compliance in such type of treatment intervention is of utmost importance. This case report presents the correction of single tooth crossbite with the removable posterior bite plane along with Z-spring. Various other treatment modalities have been also proposed to correct an anterior dental crossbite, such as tongue blades, reversed stainless steel crowns, fixed acrylic planes, bonded resin-composite slopes, and removable acrylic appliances incorporating finger springs. This treatment modality is possible in the early stages of developing malocclusion. Children with untreated anterior crossbite could develop complications such as gingiva recession, TMJ dysfunction, and worsening of mandibular displacement. As self-correction is rare in these alterations, early interception is recommended to allow normal occlusion and facial development.

Management of Angle Class I malocclusion with crowding and anterior crossbite by unilateral premolars extraction

Crowdedteethhave a major negative influence on the dentomaxillary system. In addition toaesthetic concerns, which arethe main motivating factor for requesting dentaltreatment,there areother functionalconsequences that canbe factors favoringthe onset anddevelopment ofperiodontaldisease.This articlereportsthe treatmentofsevere crowding anddeepbite withpremolar extraction.A 20-year-old female presented withsevere crowding of the upper and lower anterior teeth. Thepatient complain- edabout facialaesthetics and convexprofile, andhadboth lower first molars extracted about 2 years ago. There was agenitionof the right upper first premolar,deep bite and anterior crossbite. Clinicalexamination showed a Class I relationship forthe teeth and cephalometric measurementsshowed a Class IIskeletal tendency.The left upper first premolar was extracted for anterior crowding correction andoverbitecorrection. Thespace ofthe missing lower first molar was used for correction oflower crowd- ing.A two-step extraction technique was used to correct the patient's verticalplaneandprofile. It is concludedthat upper first premolar extraction is one of the options in the treatment of crowding. Unilateral extraction treatment can be performed to achieve an aesthetically pleasing and functionally stable occlusion.

Management of anterior crossbite using various treatment modalities

Anterior crossbite is the term used to define an occlusal problem involving palatal positioning of the maxillary anterior teeth relative to the mandibular anterior teeth. It has a reported incidence of 4-5% and is usually the result of a palatal malposition of the maxillary incisors resulting from a lingual eruption path. Three male patients reported to the department of pediatric and preventive dentistry, Sri Aurobindo College of Dentistry with the chief finding of anterior cross bite were treated with different fixed and removable treatment modalities. During the early correction of simple and minor malocclusions, which is a part of interceptive orthodontic treatment, the anterior cross-bite is corrected more rapidly & it is achieved by removable appliances or fixed appliances.

A modified Nance appliance for space management and single tooth anterior crossbite correction: Case series

Early loss of deciduous teeth can cause the drifting of teeth reducing the space available for the eruption of permanent successors and thus maintenance of space is critical to prevent malocclusion. At times, multiple decayed teeth can occur simultaneously with a single-tooth anterior crossbite, which is a major functional concern to the dentist and esthetic concern to the parents during the developmental stage of a child. Hence, there is a need for an appliance that can cater to both conditions of space management and anterior crossbite correction concurrently. The following case series focuses on the time taken and the comfort of the patient and for the correction of crossbite using a Modified Nance palatal appliance. All three cases took an average of 1 week for crossbite correction and patients showed superior comfort and compliance.

Correction of anterior and lingual single tooth cross bite in an adult patient - A case report

Malocclusion is known to be multifactorial affecting a wide range of populations in many ways. It can have pernicious effects on the quality of life of an individual since it is associated with both aesthetic and functional matters. Crossbites, having been considered one of the most common malocclusions, also serves as a route for future problems. The objective was to treat a 22-year-old male patient who presented with a single tooth anterior and lingual crossbite. A non-extraction treatment followed by settling of occlusion which met the treatment plan was performed, delivering a corrected smile both functionally and aesthetically.

The dark side of fixed retainers: Case series

This article focuses on on the presentation and management 9 adult patients who experienced complications because of their maxillary or mandibular fixed retainers 5-33 years after orthodontic treatment. Such complications include the development of an anterior crossbite, open bite, incisal cant, and twist- and x-effects. The detrimental effects on periodontal health were highlighted, especially in the mandibular canines. A range of fixed retainer types was identified, including flexible spiral wire bonded to 4 maxillary or 6 mandibular anterior teeth, rigid wire bonded to mandibular canines only and fiber-reinforced composite fixed retainer. Orthodontic retreatment was necessary in all patients using fixed appliances or clear aligners. Radiographic findings from cone-beam computed tomography or orthopantomogram before and after retreatment are presented when available. Despite the improvement of teeth position clinically, the cone-beam computed tomography scans taken directly after the completion of orthodontic retreatment did not show notable improvement with regards to root proximity to the cortical plates. The prevention of further complications was highlighted, including the use of dual retention, remote monitoring, frequent follow-up appointments and the importance of developing clear guidelines for monitoring patients in retention for treating clinicians and general dentists to promote early detection of adverse changes.

Single Anterior Tooth Crossbite Correction in Mixed Dentition using Versatile 2x4 Appliance Along with Posterior Bite Plane: A Case Report

The period of mixed dentition is considered to be one of the most appropriate ages for getting an orthodontic treatment. Most parents have a misconception that orthodontic treatment should only be started after all of the permanent teeth have fully erupted. Early mixed dentition patients with anterior crossbites and ectopic incisors are treated versatile 2x4 appliance along with posterior bite plane. This appliance has many benefits over alternative methods, including complete control over anterior tooth positioning, excellent patient acceptance, no patient adjustment needed, and the ability to accurately and quickly position teeth. The present case report refers who reported to the department with complains irregularly placed teeth which was managed with 2 X4 appliance.

Effects of Nasoalveolar Molding on Maxillary Arch Dimensions and Malocclusion Characteristics of Deciduous Dentition Patients with Cleft Lip and Palate.

To evaluate the effects of nasoalveolar molding (NAM) therapy on maxillary arch dimensions and malocclusion characteristics in patients with unilateral (UCLP) and bilateral cleft lip and palate (BCLP). Patients in deciduous dentition were referred to the institutional department of orthodontics. The NAM group consisted of 21 patients with UCLP (mean age 4.7±0.7 years) and 12 patients with BCLP (mean age 4.8±0.7 years). Sixteen patients with UCLP (mean age 4.9±0.9 years) and 5 patients with BCLP (mean age 5.4±1.1 years) were included in the non-NAM group. The plaster models of all patients were digitized. Dental arch dimensions and malocclusion characteristics were analyzed via digital software. One-way ANOVA with Bonferroni correction was used for statistical analysis. Intercanine and intermolar widths showed statistically significant differences according to the cleft type (P<.01). There was no statistically significant effect of NAM therapy on maxillary arch parameters and malocclusion characteristics (P>.05). The prevalence of anterior crossbite was 12.1% in the NAM group, and 23.8% in the non-NAM group. NAM therapy did not affect the maxillary arch dimensions and malocclusion characteristics in patients with UCLP and BCLP. The cleft type was the main factor, leading to a significant difference in maxillary widths.

Parental knowledge, attitude and practice about anterior dental crossbite of their primary school children in Zanjan, 2020

Parental knowledge, attitude and practice about anterior dental crossbite of their primary school children in Zanjan, 2020

Anterior crossbite treatment using functional orthopedic appliance: a case report

Anterior crossbite can affect primary, mixed, and permanent dentitions. Early treatment is recommended, as it can impact facial, aesthetic, functional, and developmental aspects. The etiology of anterior crossbite is multifactorial, including dental, skeletal, and postural origins. Treatment should be defined based on age and etiology, with various therapeutic resources available for correction. In primary dentition, direct flat tracks, different types of functional orthopedic appliances, quad-helix, and facial mask can be used. In mixed dentition, fixed segmented or continuous orthodontics, elastics, and other devices can be added to the treatment. In permanent dentition, orthognathic surgery may be indicated for adults, especially in cases of anterior crossbite associated with skeletal Class III that cannot be compensated dentally. This case report describes the treatment of early mixed dentition anterior crossbite with a functional orthopedic appliance at the Orthodontic Specialization, Postgraduate Course at Modal college, Belo Horizonte, Minas Gerais, Brazil. After correction, proper chewing functions were reestablished with ideal developmental stimuli.

Keep it simple: correction of anterior cross bite – an ortho-perio interdisciplinary approach

This case report explores the treatment of a 13-year-old male patient with severe dental crowding and periodontal issues using non-extraction orthodontic treatment combined with a root coverage procedure. The patient presented with a skeletal class 1 base malocclusion, and multiple anterior crossbites, along with a compromised lower central incisor and gingival recession. Despite the option of extraction, the patient declined this approach, and the final goal was to achieve stable class 1 occlusion and an improved smile.The treatment plan utilized pre-adjusted edgewise appliance (MBT 0.022 inch slot), distalization of the canine, inversion of the maxillary right lateral bracket, and the cautious use of open coil spring in the upper and lower anterior segments. After alignment was completed, a root coverage procedure was performed on the lower right central incisor. The treatment lasted for 20 months, and the results showed successful alignment of both arches, canine protected occlusion, and improved periodontal health.Overall, this case report highlights the complex relationship between orthodontic treatment and periodontal health and the importance of careful treatment planning and patient communication to achieve successful and stable results. The non-extraction approach combined with root coverage procedure proved to be an effective treatment option for this patient, leading to an improved occlusion, smile, and periodontal health.

Optimal Treatment Timing in Orthodontics: A Scoping Review.

The appropriate timing for orthodontic intervention has been a subject of debate for a long time, concerning not only the immediate effects but also the long-term benefits of such treatment. This review aimed to find the appropriate treatment timing for the intervention of various orthodontic problems. A literature search was performed in all major databases, including PubMed and Cochrane Library, until February 20, 2023. All observational and experimental studies published in English that compared early versus late orthodontic treatment in different types of orthodontic problems were included. Data selection and charting were undertaken by a single investigator. A total of 32 studies were identified that discussed various aspects of interventions, including Class II and Class III malocclusion, pseudo-Class III malocclusion, anterior and posterior crossbite, extractions, and long-term benefits. Overall, early intervention was not found to be superior in terms of effectiveness, overall duration of appliances, and cost-benefit ratio. Early intervention should be reserved for specific conditions or localized malocclusions that have psycho-social benefits, or to significantly reduce the severity of problems to be dealt with in comprehensive treatment in the permanent dentition.

Near-Infrared Light-Activated Mesoporous Polydopamine for Temporomandibular Joint Osteoarthritis Combined Photothermal-Chemo Therapy.

The treatments generally employed for temporomandibular joint osteoarthritis (TMJOA) involve physical therapy and chemotherapy, etc., whose therapeutic efficacies are impaired by the side effects and suboptimal stimulus responsiveness. Although the intra-articular drug delivery system (DDS) has shown effectiveness in addressing osteoarthritis, there is currently little reported research regarding the use of stimuli-responsive DDS in managing TMJOA. Herein, we prepared a novel near-infrared (NIR) light-sensitive DDS (DS-TD/MPDA) by using mesoporous polydopamine nanospheres (MPDA) as NIR responders and drug carriers; diclofenac sodium (DS) as the anti-inflammatory medication; and 1-tetradecanol (TD) with a phase-inversion temperature of 39 °C as the drug administrator. Upon exposure to 808 nm NIR laser, DS-TD/MPDA could raise the temperature up to the melting point of TD through photothermal conversion, and intelligently trigger DS release. The resultant nanospheres exhibited an excellent photothermal effect and effectively controlled the release of DS through laser irradiation to accommodate the multifunctional therapeutic effect. More importantly, the biological evaluation of DS-TD/MPDA for TMJOA treatment was also performed for the first time. The experiments' results demonstrated that DS-TD/MPDA displayed a good biocompatibility in vitro and in vivo during metabolism. After injection into the TMJ of rats afflicted with TMJOA induced by unilateral anterior crossbite for 14 days, DS-TD/MPDA could alleviate the deterioration of TMJ cartilage, thus ameliorating osteoarthritis. Therefore, DS-TD/MPDA could be a promising candidate for photothermal-chemotherapy for TMJOA.

Prevalence and Influencing Factors of Mixed Dentition Malocclusion in Children Aged 6-12 Years in Jinzhou, China.

To investigate the prevalence, clinical manifestations and related risk factors of malocclusion in schoolchildren of Jinzhou City, China. A total of 2162 children aged 6-12 years were randomly selected from various districts of Jinzhou. Conventional clinical examination was performed by stomatologists, and the results were described based on different clinical manifestations of malocclusion and individual normal occlusion. Further, a questionnaire survey completed by children's parents or guardians provided the demographic data, lifestyle, and oral habits. The distribution of individual normal occlusion and malocclusion was documented in percentage, and Pearson's Χ2 was used for two-factor analysis. The data were statistically analysed using SPSS software (version 25.0) with a significance level of α = 0.05. A total of 1129 boys and 1033 girls were included in this study, i.e. 52.2% and 47.8% of the total number of children, respectively. The prevalence of malocclusion in children aged 6-12 years old in Jinzhou was 67.9%, of which crowded dentition was the most common form, with a prevalence of 71.8%, followed by deep overbite, anterior crossbite, dental spacing, deep overjet, anterior edge-to-edge occlusion, and anterior open bite. In the logistic regression model, the results showed that BMI index had little effect on the occurrence of malocclusion (p > 0.05), while dental caries, bad oral habits, retained primary teeth, and a low labial frenum were all related to the occurrence of malocclusion (p < 0.05). Moreover, the higher frequency and duration of bad oral habits were associated with a higher likelihood of malocclusion. The prevalence of malocclusion in children aged 6-12 years in Jinzhou is high. In addition, bad oral habits (such as lip biting, tongue thrusting, biting/gnawing objects, unilateral chin supporting, and unilateral mastication) and other related risk factors (such as dental caries, mouth breathing, retention of primary teeth, and low labial frenum, etc) were associated with malocclusion.

Piezo1 mediates the degradation of cartilage extracellular matrix in malocclusion-induced TMJOA.

To evaluate the role of Piezo1 in the malocclusion-induced osteoarthritic cartilage of the temporomandibular joint. A temporomandibular joint osteoarthritis model was established using a unilateral anterior crossbite in vivo, and cartilage degeneration and Piezo1 expression were observed by histological and immunohistochemical staining. ATDC5 cells were loaded with 24 dyn/cm2 fluid flow shear stress using the Flexcell device in vitro and expression and function of Piezo1 were evaluated. After identifying the function of Piezo1 in YAP translocation under FFSS conditions, the influence of Piezo1 and YAP on metabolism-related enzymes under FFSS was detected through a real-time polymerase chain reaction analysis and western blotting. A UAC-TMJ injection model was established to observe the therapeutic effect of intra-articular injection of a Piezo1 inhibitor on osteoarthritic cartilage matrix loss. Piezo1 was overexpressed in the osteoarthritic cartilage and cultured chondrocytes under shear stress. Piezo1 Silencing inhibited the nuclear translocation of YAP and subsequently downregulated the expression of MMP13 and ADAMTS5. Intra-articular injection of the Piezo1 inhibitor, GsMTx4, could ameliorate proteoglycan degradation in malocclusion-induced TMJOA and suppressed MMP13 and ADAMTS5 expression. Our results revealed that the activation of Piezo1 promotes mechanical-induced cartilage degradation through the YAP-MMP13/ADAMTS5 signaling pathway.

Prevalence of Dental Anomalies in Various Categories of Malocclusion among Orthodontic Patients in the Kosovo Region: A Retrospective Study

Abstract Objectives The objective of this retrospective research was to investigate the prevalence and the association between dental anomalies and malocclusion in a subset of Kosovo's population. Materials and Methods This retrospective descriptive study was conducted by recruiting 557 patients; 215 (38.6%) were males and 342 (61.4%) were females. The age range was from 7 to 44 years. The exclusion criteria were employed for the sample size, and 307 of 864 patients were excluded from the study. Malocclusion groups were divided through Angle's classification, and dental anomalies were defined according to the literature. Pretreatment panoramic radiographs, medical and dental history, study casts, and photographs were included to categorize malocclusion and identify dental anomalies (i.e., hypodontia, ectopic eruption, impaction, and diastema). The data were analyzed with IBM SPSS software version 16.0. The chi-squared test was utilized to calculate the frequency and percentages of malocclusion and dental anomalies. A p-value of 0.05 was considered statistically significant. Results Five hundred and fifty-seven patient records from 2015 to 2020 were included. An increased prevalence of ectopic eruption (24.8%) was found in this study, whereas the least common was hypodontia (7.0%). The most common malocclusion was class I (46.9%). Vertical plane malocclusion demonstrated that 31.4% had a deep bite and 9.5% had an open bite. Most dental anomalies were significantly associated with class I malocclusion and least associated with class III malocclusion. Transverse malocclusion exhibited that 14% had anterior crossbite and 10.8% had posterior crossbite. Posterior crossbite was significantly less in the class III malocclusion group (p = 0.019). Conclusion The prevalence of the selected dental anomalies was overall high in our study; 557 of 864 patients faced dental anomalies. An association was seen between malocclusion and dental anomalies in the Kosovan population, especially with class I malocclusion. Deep bite was prominent in the vertical plane malocclusion, whereas anterior crossbite was the most common finding in the transverse plane. Anterior crowding was prevalent in the maxilla and posterior crowding in the mandible.

Treatment of Class III malocclusion with anterior crossbite and deepbite using temporary skeletal anchorage devices as anchorage

Treatment of Class III malocclusion with anterior crossbite and deepbite using temporary skeletal anchorage devices as anchorage

Correction of class III malocclusion using enmasse distalization with tad

Skeletal class III malocclusion in adult patients are generally managed by orthognathic surgery. However, the prognosis is poor when the patient refuses surgical line of treatment. In such cases orthodontic camouflage through dentoalveolar compensation may be attempted. Presently, with the advent of stationary anchorage, en mass distalization appears to be a common choice. This article demonstrates an en mass distalization carried out in the upper and lower arches in a class III skeletal case, refusing surgery. After initial levelling and alignment, TADs (temporary anchorage devices) were placed bilaterally mesial to the first molars in upper and lower arches. After a month, distalization was initiated with 300 gms force applied per side using elastomeric chain. At the end of the treatment, the anterior cross bite and crowding was resolved and the patients profile improved. Thus, en masse distalization with TADs appears be a good choice in class III skeletal cases refusing surgery. It is minimally invasive and cost effective.

A MULTIDISCIPLINARY APPROACH TO MANAGING BIMAXILLARY HYPERHYPODONTIA: A CASE REPORT

Bimaxillary hyperhypodontia (BHH) is a very rare numeric anomaly with a prevalence of 0.002% to 3.1% described by the presence of a supernumerary tooth in the premaxilla region and a missing mandibular incisor tooth. This case highlights the multidisciplinary management of a child presenting with BHH who complies with the recommended protocol by surgically removing the supernumerary tooth and then proceeding with orthodontic treatment for function and aesthetics. A 9-year-old healthy Malay boy presented with a fully erupted tooth 21, a labially palpable bulge of unerupted tooth 11, a missing tooth 32, and a tendency for an anterior and posterior crossbite. The radiographs showed an inverted, unerupted, conical-shaped supernumerary tooth overlapping the unerupted tooth 11 and hypodontia of tooth 32. The management was surgical removal of the supernumerary tooth and the placement of an upper removable appliance with a palatal expansion screw followed by comprehensive fixed orthodontics.

Comparison of two different methods of rapid expansion combined with maxillary protraction in the treatment of skeletal class Ⅲ malocclusion

Objective: To compare the effect of bone-anchored versus tooth-borne rapid palatal expansion (RPE) combined with maxillary protraction in the treatment of skeletal class Ⅲ patients with maxillary hypoplasia. Methods: Twenty-six skeletal class Ⅲ patients with maxillary hypoplasia in the late mixed or early permanent dentition were selected. All the patients underwent RPE combined with maxillary protraction in the Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University from August 2020 to June 2022. The patients were divided into 2 groups. Thirteen patients were enrolled in the bone-anchored RPE group [4 males and 9 females, aged (10.2±1.7) years] and the others were in the tooth-borne RPE group [5 males and 8 females, aged (10.1±1.0) years]. Ten sagittal linear indices [Y-Is distance (the distance from the incisor edge of the maxillary incisor to the vertical reference axis), Y-Ms distance (the distance from the mesial contact point of the maxillary first molar to the vertical reference axis), the relative distance between the maxillary and mandibular molars, overjet, etc.], 6 vertical linear indices [PP-Ms distance (the distance changes from Ms to the palatal plane), etc.] and 8 angle indices [SN-MP angle (the upper external angle of the intersection of the sella-nasion plane and the mandibular plane), U1-SN angle (the lower internal angle of the intersection of the long axis of the maxillary central incisor and the sella-nasion plane), etc.] were measured on the cephalometric radiographs before and after the treatment. Six coronal indicators (the inclination of the left and right first maxillary molar, etc.) were measured on cone-beam CT images before and after the treatment. The proportion of skeletal and dental factors in the changes of overjet were calculated. The differences of the index changes between groups were compared. Results: After the treatment, the anterior crossbite were corrected in both groups, and classⅠor classⅡ molar relationship were attained. In bone-anchored group, the changes of Y-Is distance, Y-Ms distance and maxillary and mandibular molar relative distance were (3.23±0.70), (1.25±0.34) and (2.54±0.59) mm, respectively, significantly less than those in the tooth-borned group in which the corresponding changes were (4.96±0.97) mm (t=-5.92, P<0.001), (3.12±0.83) mm (t=-7.53, P<0.001) and (4.92±1.35) mm (t=-5.85, P<0.05), respectively. The change of overjet in the bone-anchored group was (4.45±1.25) mm, significantly less than that in the tooth-borned group (6.14±1.29) mm (t=-3.38, P<0.05). Skeletal and dental factors accounted for 80% and 20% of the overjet changes in the bone-anchored group, respectively. While in the tooth-borned group, skeletal and dental factors accounted for 62% and 38% of the overjet changes, respectively. The PP-Ms distance change in the bone-anchored group [(-1.62±0.25) mm] was significantly less than that in the tooth-borned group [(2.13±0.86) mm] (t=-15.15, P<0.001). The changes of SN-MP and U1-SN in the bone-anchored group were -0.95°±0.55° and 1.28°±1.30°, respectively, significantly less than those corresponding indices in the tooth-borned group (1.92°±0.95°, t=-9.43, P<0.001; 7.78°±1.94°, t=-10.04, P<0.001). In the bone-anchored group, the inclination changes of maxillary bilateral first molars in the left and right sides were 1.50°±0.17° and 1.54°±0.19°, significantly less than the corresponding indices in the tooth-borned group (2.26°±0.37°, t=6.47, P<0.001; 2.25°±0.35°, t=6.81, P<0.001). Conclusions: The bone-anchored RPE with maxillary protraction could reduce the adverse tooth compensation effect, including the protrusion of maxillary anterior incisors, the increase of overjet and mandibular plane angle, and the mesial movement, extrusion and buccal inclination of maxillary molars.