Anterior Crossbite Research Articles

Parents’ awareness towards preventive and interceptive orthodontic treatment

ObjectivesThis study aims to assess the awareness and acceptance of preventive and interceptive orthodontic treatment among Saudi perents.MethodsThe study used a 29-question questionnaire, covering parents’ demographic data, parents’ awareness of malocclusion and habits, and parents’ acceptance of treatment. It included visuals of different malocclusions, normal occlusion, and specific habits.ResultsParents mostly recognized single anterior tooth crossbite (95.78%) as a problem that need early intervention, followed by skeletal Class II (94.16%) and severe lower incisor crowding (93.51%). Regarding oral habits, parents were most aware of thumb sucking (91.03%), followed by tongue thrusting (84.22%). Ninety seven percent of participating parents expressed high acceptance of early orthodontic intervention, mostly to avoid more complicated treatment or surgery. However, a few parents refused early treatment, mainly because they preferred to wait until the eruption of all permanent teeth.ConclusionsThe majority of parents demonstrated a high level of awareness and willingness to pursue early treatment.

Extraction camouflage treatment of a skeletal Class III malocclusion with severe anterior crowding by miniscrews and driftodontics in the mandibular dentition

An 18-year-old Chinese woman presented with chief complaints of crowded teeth and mild mandibular prognathism. Clinical and imaging examinations revealed a concave profile, a protruded chin, increased lower anterior facial height mild, skeletal Class III and Angle’s Class III malocclusion, with anterior crossbites, and crowded teeth. Extraction camouflaged therapy combined with miniscrews skeletal anchorage was employed to relieve crowding and retract the mandibular anterior teeth. The total active treatment time was 31 months. After treatment, functional occlusion and smile esthetics were significantly improved.

Treating Angle’s Class III with anterior cross bite with Jaw Functional Orthopedics. Clinics and Laboratory appliance construction protocols.

Jaw Functional Orthopedics (JFO) is a branch of dentofacial orthopedics and, in Brazil a specialty. It works with the triad stimulus - central nervous system (CNS) integration – response. These stimuli are generated in the stomatognathic system (SS) by removable appliances that change the mandibular posture in a protocol which varies with the type of malocclusion and the facial characteristics of the individual, among other factors as pain, for instance. Angle’s Class III malocclusion is one of the most challenging to treat with any malocclusion treatment protocol (Jaw Functional Orthopedics, Orthodontics, orthognathic surgery among others). The clinical diagnosis if it is a false or a true Class III is fundamental for treatment planning. The aim of this manuscript is show in which cases Jaw Functional Orthopedics is indicated and how functional orthopedic appliance construction and clinical managements must be done to achieve good results through a class III treatment case report.

Effectiveness of clear aligner versus removable inclined plane in treatment of anterior crossbite in mixed dentition: A randomized clinical trial.

This study aimed to compare the efficacy of clear aligners and removable inclined planes (RIP) in management of anterior crossbite in late mixed dentition patients using a 3D digital model. Twenty-four patients with functional anterior crossbite, aged 8 to 12 years old, were randomly assigned to two parallel groups: the clear aligner (CA) group with a mean age of 10.74 ± 1.1 years, treated with clear aligner, and the RIP group with a mean age of 10.54 ± 1.06 years. Digital models were obtained for each patient before (T0) and after 4 months of starting the treatment (T1) using an intraoral scanner. The T0 to T1 digital model was superimposed to assess the primary outcome, labial movement of the maxillary incisors. For each model, the following secondary outcomes were evaluated: overbite, intermolar width (IMW), incisor leveling, arch perimeter (AP), and mesiodistal angulation. Data analysis included descriptive statistics, paired t tests, independent t tests, one-way ANOVA, and Tukey's HSD test. There was no significant difference between CA and RIP groups regarding overjet, overbite, incisor leveling, and mesiodistal angulation of the maxillary incisors (P < 0.05). However, a significant difference was found between two groups in IMW, AP, and incisor superimposition (P < 0.05). The CA group showed a more significant increase in labial movement of maxillary incisors, IMW, and AP compared to the RIP group. However, both treatment protocols were effective in treating anterior crossbite. This study was recorded in the ClinicalTrials.gov database (identifier: NCT06015386).

Treatment of severe skeletal Class III patient with buccally impacted canines and severe crowding using a bone-anchored facemask and Alt-RAMEC protocol: A case report

A 14-year-10-month-old female patient presented with a chief complaint of being dissatisfied with the looks of her teeth and face. She had a pronounced misalignment of her dentition, defined by a Class III skeletal relationship and an average vertical proportion of the face. The patient had an anterior crossbite and bilateral posterior crossbites, with the upper left canine impacted in a buccal position. After a comprehensive consultation with the patient and her parents, we decided to implement a treatment strategy that entailed utilizing a maxillary bone borne expander in conjunction with a facemask. This treatment followed a protocol that consisted of alternating between rapidly expanding and contracting the maxilla. The purpose of this was to stimulate the advancement of the midface. After the treatment was carried out to treat the crossbites, a fixed appliance (MBT prescription) was bonded on the maxillary and mandibular arches. In addition, four premolars were extracted, and the upper left canine was brought to occlusion. Temporary anchorage devices were used in the lower arch to provide skeletal anchorage. The patient underwent active treatment for a period of 24 months following which we were able to achieve satisfactory occlusal and esthetic results.

ORTHODONTIC CORRECTION OF ANTERIOR AND POSTERIOR CROSSBITES IN A CLASS III PATIENT WITH SINGLE TOOTH EXTRACTION – A CASE REPORT

The present paper discussed the treatment of a 13-year-old female having a Class III molar and canine relationships (C3M) in the right side and complicated by anterior and unilateral posterior crossbite in the left side. After discussing treatment plans with the patient, a unilateral extraction of tooth #44 to shift her midline and treat her right C3M canine relationship was scheduled. Crossbite elastics were used for her left from palatal side of maxillary posterior teeth to buccalside of mandibular posterior teeth. 2 years post follow up, correction of both the anterior and posterior crossbites were achieved, leading to enhanced functional occlusion and improved overjet and overbite measurements.

Case report of 2-year-old child with congenital torticollis and crossbite treated with functional orthopedics of the jaws

Satisfactory chewing is performed by an alternating bilateral pattern that depends on occlusal balance, the absence of occlusal interference or premature contacts, stability, good functioning of the temporomandibular joints (TMJs) and neuromuscular maturation. If mandibular functional imbalances occur, discrepancies in maxillomandibular development and future facial asymmetries may occur. The objective of this work was to remove dental interferences that cause anterior and posterior crossbite, as well as those that prevent the good execution of symmetrical lateroprotrusive movements (right side/left side), through occlusal adjustment and subsequent correction of maxillary asymmetry using the device; encapsulated. Clinical case report of a two-year-old female patient, with unilateral crossbite on the right side (anterior/posterior), diagnosed with congenital torticollis, difficulty breastfeeding and difficulty performing alternating lateral movements. with follow-up until the complete deciduous dentition. The treatment was divided into three stages. The first step was to correct the unilateral crossbite (anterior and posterior), on the right side, by making occlusal adjustment using a grid, and later with the addition of Planas Direct Tracks resin. The second stage used an encapsulated device to correct maxillary asymmetry. The third stage was completed after the eruption of the deciduous second molars with the functional analysis of lateral movements plus occlusal adjustments using a grid. Correction of unilateral crossbite (anterior and posterior) on the right side, symmetrization of the maxilla and better execution of lateroprotrusive movements. The results obtained in this case report suggest that the occlusal adjustment removed the dental interferences that caused the anterior/posterior crossbite on the right side; the maxilla was symmetrized with the distalization of sector 63-65, and the removal of dental interferences that prevented lateral movements made it possible to perform lateroprotrusive movements (right/left side) after the complete eruption of the primary teeth.

Stress causes lipid droplet accumulation in chondrocytes by impairing microtubules.

Abnormal mechanical stress is intimately coupled with osteoarthritis (OA). Microtubules play a vital role in the regulation of mechanotransduction and intracellular transport. The purpose of the present study was to investigate the impact of stress-induced microtubule impairment on intracellular transport and lipid droplet (LD) accumulation in chondrocytes. Rats were subjected to unilateral anterior crossbite (UAC), which is inducible for degeneration of temporomandibular joint (TMJ) cartilage. Chondrocytes derived from rat TMJ cartilage were subjected to fluid flow shear stress (FFSS) and analyzed via LCMS/MS-based proteomics. The microtubule destabilization agent nocodazole and/or the microtubule stabilizer docetaxel were used in the UAC and FFSS models. In both FFSS- and UAC-treated chondrocytes, decreased acetylated α-Tubulin (ac-Tubulin) expression and LD accumulation were observed. Proteomic data revealed increased levels of the LD-associated protein perilipin 3 (Plin3) and decreased levels of cytoskeleton components in FFSS-treated chondrocytes. Live-cell imaging revealed that the colocalization of LDs with lysosomes was significantly decreased after FFSS treatment. Impairment of microtubules by nocodazole reduced the protein level of ac-Tubulin and disrupted the Hsc70-mediated interaction between Plin3 and Lamp2a, as shown by co-IP assays. In contrast, docetaxel reversed the suppression of ac-Tubulin expression, reduced the accumulation of LDs, and decreased the expression of Plin3 in chondrocytes exposed to FFSS and UAC, and docetaxel ameliorated UAC-induced osteoarthritic lesions in the TMJ cartilage. Microtubule impairment under aberrant stress conditions disrupts intracellular transport and blocks lipophagy, causing LD accumulation in chondrocytes. Microtubule stabilization could be a new approach for treating stress-induced cartilage degeneration.

DIAGNOSIS OF THE ALVEOLAR BONE CONDITION IN CASES OF TEETH WITH ANTERIOR CROSS BITE

Anterior cross bite is an occlusal etiological factor for the occurrence of gingival recession and resorption of the alveolar bone. Aim: To examine the condition of the alveolar bone in relation to incisor inclination in subjects with anterior cross bite. Materials and methods: Sixty one eligible subjects, with a mean age of 25.66±10.51 years, presented with anterior cross bite of a single teeth or a group of teeth. The distribution of patients by sex is women-42.6% and men-57.4%. The inclination of the upper and lower incisors was evaluated and analysed with Steiner C method. The bone resorption in the two jaws (distance from the enamel-cement junction of the incisors up to the beginning of the alveolar bone) was measured up to 0.01 mm. Results: Protrusions constituted a higher percentage than retrusion in both jaws. The mean value of bone resorption in the maxilla of subjects with retrusion was 4.01mm, whereas in subjects with protrusion, it was 3.42mm (p = 0.062). The mean value of bone resorption in the mandible of subjects with retrusion was 4.56mm, whereas in subjects with protrusion, it was 4.36mm. The bone resorption mean of the patients with retrusion in the mandible was 0.55mm higher than the mean of the patients with retrusion in the maxilla with high statistical significance (p = 0.008). Conclusion: Higher levels of bone resorption were observed in the mandible as compared to the maxilla. A significant linear relationship was found between the inclination of the incisors and the degree of bone resorption.

The Prevalence and Possible Association of Different Types of Temporomandibular Disorders Among Young Adult Patients With Anterior and/or Posterior Crossbite: A Cross-Sectional Study.

This study aimed to investigate the prevalence and the possible association of the different types of temporomandibular disorders among young adult patients with anterior and/or posterior crossbites. This cross-sectional study included 584 individuals (259 male participants and 325 female participants) aged 18-29. The temporomandibular joint examination was conducted according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I tests. In addition, dental and occlusal examinations were conducted to investigate the presence or absence of anterior and/or posterior crossbites. A chi-square test was used to evaluate any possible association between TMDs and gender and crossbite groups. A binary logistic regression analysis was performed to compute the odds ratios and assess the predictability of TMDs based on the presence or absence of crossbites. Here, 47.1% of participants had a positive TMD. The presence of muscle disorder, disc displacement, and other joint disorders among participants was 16.4%, 26.7%, and 25.7%, respectively. The prevalence of TMDs in the female participants was significantly greater than in male participants (P= 0.046). There was a significant difference in the prevalence of disc displacements among crossbite groups (P= 0.026), and the anterior crossbite group had the highest prevalence (41%). There was no significant difference in the prevalence of muscle disorder and other joint disorders among crossbite groups (P= 0.149; P= 0.052, respectively). According to the binary logistic regression, only an anterior crossbite was significantly associated with higher predictability for disc displacement and other joint disorders (OR= 2.4; P= 0.008, OR= 2.34; P= 0.01, respectively). The presence of only a posterior crossbite was significantly associated with higher predictability for the occurrence of the disc displacement (OR= 1.58; P= 0.03). The risk of development of disc displacement may be increased by the presence of an anterior or posterior crossbite. Also, the risk of developing other joint disorders may be increased by the presence of only an anterior crossbite.

Efficacy of the maxillary anterior segmental distraction osteogenesis in patients with cleft lip and palate.

Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient's facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients. A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included. Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95% CI, 4.11° to 8.74°) and A-McNamara rose by 7.29mm (95% CI, 6.21mm to 8.37mm). The maxilla also showed a slight counterclockwise rotation; however, this reached no statistical significance. The mandibular position did not vary remarkably. Moreover, a significant increase in upper anterior tooth tipping and overjet, a decrease in overbite, and an improvement in nasolabial soft tissue were observed. MASDO might be a valid therapy option for CLP patients. It causes a significant increase in the maxillary length, anterior tooth crossbite, and nasolabial soft tissue were also greatly improved.

Influence of Oral Habits on Pediatric Malocclusion: Etiology and Preventive Approaches.

Teeth malocclusion refers to the misalignment of teeth and improper occlusion of the upper and lower jaws when the mouth is closed, which can lead to both aesthetic and functional issues such as difficulties with chewing, biting, and speech. These challenges may further contribute to broader health concerns. One of the major contributing factors to malocclusion in children is the presence of certain oral habits. Research has established a strong association between habits such as thumb sucking, tongue thrusting, and mouth breathing and various malocclusion patterns, including anterior open bite, proclination, crowding, and posterior crossbite. This review seeks to examine these three primary deleterious oral habits, their impact on malocclusion, and effective prevention strategies to address these habits in pediatric patients.

Non-coding RNA alterations in occlusal disharmony-induced anxiety-like behaviour.

Occlusal disharmony (OD) may induce anxiety-like behaviours; however, the underlying mechanism remains unclear. Herein, we explored the expression profiles of non-coding RNAs (ncRNAs), along with their biological function and regulatory network, in anxiety-like behaviour induced by OD. Occlusal disharmony was produced by anterior crossbite of C57BL/6 mice. Behavioural tests, corticosterone (CORT) and serotonin (5-HT) levels were used to measure anxiety. In addition, RNA sequencing was used to screen all differentially expressed (DE) ncRNAs. Moreover, the RNA-binding proteins interacting with ncRNAs were predicted by the ENCORI database and confirmed using western blots. The significant differences in behavioural tests and CORT suggested the successful induction of anxiety-like behaviour by OD. In OD mice, ncRNAs were significantly dysregulated. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggested that the DE ncRNAs were enriched in anxiety-related pathways. CircRNA10039 was upregulated, and PTBP1 was predicted to interact with circRNA10039. In addition, KEGG pathway analysis showed that PTBP1 may be associated with messenger RNA biogenesis and spliceosomes. OD induced by anterior crossbite can lead to the anxiety-like behaviours. During this process, ncRNA also changes. CircRNA10039 and PTBP1 may play a role in OD-induced anxiety-like behaviours.

COMBINED ORTHODONTIC - SURGICAL TREATMENT OF SEVERE SKELETAL CLASS III MALOCLUSSION

Severe skeletal Class III caused by mandibular prognathism often requires a combined orthodontic and surgical treatment to ensure a stable therapeutic outcome. This case presents the therapeutic approach for a male patient who had a 1/2 / Class III malocclusion, an anterior open bite of 3 mm, anterior crossbite and a concave profile before initiating orthodontic treatment. The initial lateral cephalogram indicated mandibular prognathism (SNB 83°), a skeletal Class III (ANB -1°) with a tendency towards an open bite (B 31°), proclination of the upper incisors (I/SpP 59°), and retroclination of the lower incisors (i/ MP 92°). Additionally, an increased mandibular corpus length of 4 mm was observed. The second lateral cephalogram, taken immediately before surgical intervention indicated a skeletal Class III (ANB -3°), an increased mandibular corpus by 5.85 mm, and corrected inclinations of the upper and lower incisors. Presurgical treatment with fixed appliances lasted 36 months, followed by bimaxillary surgery. Postsurgical orthodontic treatment lasted 8 months, during which the patient wore vertical intermaxillary elastics to establish a stable occlusion. At the end of the treatment, Class I occlusion was achieved with proper overbite and overjet, and a harmonious facial profile. The post-surgical lateral cephalogram showed correction from Class III to Class I skeletal relationship, proper inclination of the upper and lower incisors, and corrected mandibular corpus length. Combined orthodontic - surgical treatment can effectively correct severe skeletal discrepancies caused by mandibular overdevelopment.

Type V collagen exhibits distinct regulatory activities in TMJ articular disc versus condylar cartilage during postnatal growth and remodeling

Understanding matrix molecular activities that regulate the postnatal growth and remodeling of the temporomandibular joint (TMJ) articular disc and condylar cartilage will enable the development of effective regenerative strategies targeting TMJ disorders. This study elucidated the distinct roles of type V collagen (collagen V) in regulating these two units. Studying the TMJ of young adult Col5a1+/− mice, we found that loss of collagen V resulted in substantial changes in the proliferation, clustering and density of progenitors in condylar cartilage, but did not have a major impact on disc cells that are more fibroblast-like. Although loss of collagen V led to thickened collagen fibrils with increased heterogeneity in the disc, there were no significant changes in local micromodulus, except for a reduction at the posterior end of the inferior side. Following the induction of aberrant occlusal loading by the unilateral anterior crossbite (UAC) procedure, both wild-type (WT) and Col5a1+/− condylar cartilage exhibited salient remodeling, and Col5a1+/− condyle developed more pronounced degeneration and tissue hypertrophy at the posterior end than the WT. In contrast, neither UAC nor collagen V deficiency induced marked changes in the morphology or biomechanical properties of the disc. Together, our findings highlight the distinct roles of collagen V in regulating these two units during postnatal growth and remodeling, emphasizing its more crucial role in condylar cartilage due to its impact on the highly mechanosensitive progenitors. These results provide the foundation for using collagen V to improve the regeneration of TMJ and the care of patients with TMJ disorders. Statement of significanceSuccessful regeneration of the temporomandibular joint (TMJ) articular disc and condylar cartilage remains a significant challenge due to the limited understanding of matrix molecular activities that regulate the formation and remodeling of these tissues. This study demonstrates that collagen V plays distinct and critical roles in these processes. In condylar cartilage, collagen V is essential for regulating progenitor cell fate and maintaining matrix integrity. In the disc, collagen V also regulates fibril structure and local micromechanics, but has a limited impact on cell phenotype or its remodeling response. Our findings establish collagen V as a key component in maintaining the integrity of these two units, with a more crucial role in condylar cartilage due to its impact on progenitor cell activities.

Occlusal disharmony promotes anxiety-like behaviours by suppressing Sirt1.

Previous studies have indicated that occlusal disharmony (OD) can promote anxiety-like behaviours. However, the specific molecules involved in the development of anxiety-like behaviours and their underlying mechanisms remain unknown. OD was produced by anterior crossbite of female mice. We measured the anxiety levels of mice in each group and screened the hippocampal mRNA expression profiles of mice in the control group and OD group. The role of target mRNA in OD-induced anxiety-like behaviours was evaluated and we preliminarily explored the possible downstream pathways. The results suggested that OD can induce and promote anxiety-like behaviours with/without chronic unpredictable mild stress. We found that Sirt1 was significantly downregulated within the hippocampus in OD mice. In addition, the downregulation of Sirt1 within the hippocampus in OD and control mice promoted anxiety-like behaviours, increased acetylated histone H3 expression and decreased Dnah12 transcription levels. In contrast, in OD mice subjected to an injection of resveratrol, there was a remission of anxiety-like behaviours and an upregulation of Sirt1 in the hippocampus, the effects of which were accompanied by decreased acetylated histone H3 expression and increased Dnah12 transcription levels. OD leads to increased sensitivity to chronic stress in mice, resulting in anxiety-like behaviours. During this process, Sirt1 acts as an effective factor in the regulation of OD-induced anxiety-like behaviours. OD, as a stressor, could induce anxiety-like behaviours. It investigates the impact of OD (a stressor) on the molecular genetic of the pathophysiology of major neuropsychiatric disorders.

Effects of occlusal hypofunction on root surface area in patients exhibiting anterior crossbite in skeletal Class III malocclusion: a CBCT study

ABSTRACT Purposes To evaluate and compare the effects of occlusal hypofunction on root surface areas (RSAs) of permanent teeth in patients with Class III and Class I skeletal relationships. Materials and Methods Thirty-two CBCT images of all permanent maxillary and mandibular teeth, except the third molars, from 16 patients (mean age 23.71 ± 4.04 years) exhibiting Class III skeletal relationships and 16 patients (mean age 24.53 ± 4.91 years) exhibiting Class I skeletal relationships were imported into the Mimics software version 15.01. The outer boundaries of the teeth in two-dimensional images were manually identified on each CBCT slice along the coronal, sagittal, and axial planes to construct three-dimensional models. The tooth models were transferred into 3-matic version 7.01 to specify cementoenamel junctions and calculate RSAs. Intra-examiner reliability was assessed using the intra-class correlation coefficient. The RSAs of each tooth type from the two groups were illustrated and compared using independent t-tests (p < 0.05). Results The RSAs of the maxillary second molars in the skeletal Class III group were significantly higher than those in the skeletal Class I group. There were no significant differences in RSAs between the two groups regarding other tooth types. Conclusions Young adults exhibiting Class III skeletal relationships exhibited significantly greater RSAs in the maxillary second molars. This might be related to occlusal hypofunction during dental root formation.

A novel approach for posterior bite collapse in an adult with crossbite anterior using a 3D-printed bite riser

Background: Managing an adult patient presenting with an anterior crossbite in conjunction with posterior bite collapse (PBC) is a difficult challenge. Purpose: The purpose of this case study is to highlight the accuracy that can be attained with the utilization of a three-dimensional (3D) printed bite riser in the correction of PBC accompanied by an anterior crossbite in an adult patient with Class III malocclusion. Case: A 64-year-old male complained of being unable to chew properly. Extraoral examination revealed a concave profile with a protrusive mandible. The patient exhibits a 5 mm anterior crossbite and has missing lower posterior molars, resulting in bilateral PBC. The cephalometric analysis revealed skeletal Class III patterns (SNA: 82.19o; SNB: 86.34o; ANB: -4.15°), with protrusion and counterclockwise rotation of the mandible (SN-OP: 3.84o). Case Management: By utilizing a 3D-printed bite riser in conjunction with temporary anchoring devices (TADs), it is possible to resolve the issue of an anterior crossbite accompanied by PBC. This is achieved by repositioning the elongated posterior segments on both sides of the maxilla to generate vertical space for mandibular tooth rehabilitation, retracting the anterior segment, and narrowing the lower arch. Simultaneously, the crossbite on both sides was corrected, a Class I and ideal overbite and overjet were achieved, the occlusal vertical dimension increased, the occlusal plane angle was corrected (7.51o), and an acceptable ANB angle (-1.36°) was accomplished. The treatment lasted 18 months and yielded sustained results after a one-year retention period. Conclusion: Integrating 3D printing technology in orthodontic treatment offers numerous options for managing challenging cases such as PBC while also reducing the treatment length. The patient was satisfied with the results achieved.

Current Trends in Pediatric Orthodontics: A Comprehensive Review.

Pediatric orthodontics is a critical field focusing on the diagnosis, prevention, and treatment of dental and facial irregularities in children. This comprehensive review explores current trends and methodologies in pediatric orthodontics and discusses the multifactorial etiology of malocclusions, including genetic, environmental, and disease-related factors. The importance of proper diagnosis is highlighted, and the extraoral, intraoral, and functional evaluations essential for effective treatment planning are detailed. Various orthodontic conditions such as Class III and Class II malocclusions, abnormal oral habits, arch length discrepancies, anterior and posterior crossbites, open bites, and deep bites are examined in depth. The review also addresses the role of temporomandibular joint disorders (TMDs) and obstructive sleep apnea (OSA) in pediatric patients, emphasizing the need for early and accurate diagnosis to facilitate appropriate intervention. The use of clear aligners in early orthodontic intervention is evaluated given their efficacy and improved patient satisfaction compared to traditional appliances. Additionally, the article discusses the non-advisability of early interception for certain self-correcting malocclusions and the limitations of pediatric orthodontic treatment, including compliance-related issues and the unique anatomical considerations of deciduous dentition. This review aims to provide a detailed understanding of contemporary practices and challenges in pediatric orthodontics, offering insights for clinicians to enhance treatment outcomes and patient care.

PREVALENCE OF MALOCCLUSION IN CHILDREN WITH MIXED DENTITION IN VISNAGAR: A CROSS-SECTIONAL RETROSPECTIVE STUDY

Background: Malocclusion is currently understudied in the literature in Visnagar town of Gujarat Therefore, thecurrent research aimed to ascertain the prevalence of malocclusion and its various paradigms among children with mixed dentition of age between 6-14 years. Aim: To establish the Prevalence of various aspects of malocclusion amidst children ages, 6-14 years who visited the department of Pediatric dentistry - A Retrospective Study. Methodology: A Retrospective, Cross-Sectional study among children aged 6-14 years was conducted for the duration of 2020-22. The data was gathered in terms of intraoral photographs of children with mixed dentition phases. Out of the total 350 patient photographs assessed, 150 adhered to the conditions for inclusion. Various Occlusal traits like molar relations, midline shift, open bite, crossbite, and scissor bite were evaluated. The Association of age and gender specificity of various occlusal traits was assessed and tabulated. Results:Class 1 malocclusion was most prevalent among children (66.3%) followed by End on the relation (22%), Class 2 division 1 (7.3%), Class 3 (3.3%), and least seen was Class 2 division 2 (0.6%). Crossbite prevalence was 17.3%, among which the most commonly seen was Anterior single teeth crossbite (58%) and the least observed was unilateral segmental crossbite (4%). Reverse overjet and Overbite observed were 4% and 2% respectively Conclusion: Early diagnosis of developing malocclusion would facilitate appropriate interception in mixed dentition with better outcomes.