Treatment Of Posterior Crossbite Research Articles

Effectiveness of removable expander appliances in posterior crossbite: A review of the literature

Objective: To evaluate the effectiveness of removable expander appliances in the treatment of posterior crossbite by reviewing and analyzing clinical studies, scientific articles and published case reports. Background: Posterior crossbite is a dental malocclusion characterized by a transverse misalignment of the upper and lower teeth, where the upper teeth bite into the lower teeth. This condition can affect one or more dental organs and if left untreated, can lead to functional and esthetic problems, as well as imbalances in maxillofacial growth. Early correction of posterior crossbite is crucial to avoid future complications such as uneven tooth wear, temporomandibular dysfunction and facial asymmetries, and different treatment methods have been used, including removable appliances. Methodology: The research was structured from a search tree (PubMed, Scielo, Google Scholar, Dialnet, Scopus), with keywords such as: removable expandable appliance; posterior crossbite; removable orthodontics; treatment efficacy AND posterior crossbite; posterior crossbite NOT fixed appliance. Conclusions: Removable expander appliances are an effective option for treating posterior crossbite in children. Studies show that these devices correct malocclusion, promote maxillary growth and improve dental alignment. The effectiveness of the treatment depends on the cooperation of the child and parents. The choice of appliance should be based on a careful evaluation of the patient's needs, considering cooperation, severity of the malocclusion and the preferences of the patient and the orthodontist.

“Piezocision assisted orthodontics: Already 14 years…”

Piezocision™ assisted orthodontics as a technique was first published 14 years ago. This technique has evolved into a treatment concept that allows the orthodontist to treat successfully challenging cases by creating differential anchorage in three planes while maintaining or enhancing the patients’ periodontal phenotype. Technical advances in digital dentistry over the past 10 years have brought some important innovations to Piezocision™ assisted orthodontic surgery. Dynamic Navigated Piezocision™ allows the surgeon to see the corticotomies in REAL TIME on the monitor screen, thus avoiding roots, anatomical structures and getting to proper depth. Piezocision™ allows for Precision orthodontics. In the past 10 years it has helped in distalization mechanics, bite opening, severe torque issues, treatment of posterior crossbites in adults, posterior open bites, anterior open bites, alveolar insufficiencies and impacted teeth eruption.

Early Detection and Treatment of Posterior Crossbites in Interceptive Orthodontics: A Review

Abstract: Posterior crossbites represent a common malocclusion in orthodontics that, if left untreated, can lead to various dental and skeletal complications. This review article aims to provide a comprehensive overview of the early detection and treatment of posterior crossbites in interceptive orthodontics. By examining the current literature and clinical practices, we highlight the importance of early intervention, various diagnostic methods, and treatment modalities available to manage posterior crossbites effectively.

Orthodontic treatment of children with anterior open bite and posterior crossbite: An analysis of the stomatognathic system.

Dental malocclusions are deviations from normalities due to the inadequate growth and development of the dental arch which provides functional changes to the stomatognathic system. The aim of this longitudinal study was to evaluate the electromyographic activity (EMG) the masseter and temporalis muscles, strength of the orofacial tissues and occlusal force of children with anterior open bite (n=15) and posterior crossbite (n=20), 7 days after the removal of the orthodontic apparatus. A fixed horizontal palatal crib was used in the treatment of anterior open bite and the fixed appliances Hyrax or MacNamara was used in the treatment of posterior crossbite. EMG of the masticatory muscles was recorded using an electromyograph with wireless sensors during mandibular tasks. Habitual chewing was assessed using the integral of the linear envelope of the electromyographic signal in the masticatory cycles. The strength of the tongue and facial muscles was measured using the Iowa Oral Pressure Instrument. T-Scan was used to analyze the force of occlusal contact. Molar bite force was measured by digital dynamometer. Significant differences (p<0.05) were found in the EMG data of the masseter and temporalis muscles in the static and dynamic mandibular tasks. There were no significant difference in strength of orofacial tissues, occlusal contact force and molar bite force 7 days after the removal of the orthodontic apparatus. The results of this study suggest that the orthodontic treatment of anterior open bite and posterior crossbite in children promoted functional alteration in the electromyographic activity of masseter and temporalis muscles.

Maxillary expansion methods

Gustė Markevičiūtė1, Vilija Berlin1,2 1Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania 2Vilnius University Hospital Zalgiris Clinic, Vilnius, Lithuania Abstract Background. Posterior crossbite is a common malocclusion usually caused by insufficient growth of maxilla. In Lithuania, the prevalence of crossbite during mixed or early permanent dentition is approximately 30%. Generally, posterior crossbite does not cause any pain or chewing difficulties in children, though, if not treated, it can lead to abnormal movement of the mandible, strain of the temporomandibular joint, skeletal facial assymetry or obstructive sleep apnea. This type of malocclusion usually does not self-correct, so orthodontic maxillary expansion is needed. Maxillary expansion technique is dependent on patient’s age and his midpalatal suture ossification level. Aim: to analyze the scientific literature about treatment of posterior crossbite and maxillary expansion methods. Methods: literature sources were selected from PubMed and Cochrane Library scientific databases, using the keywords in the original language: “posterior crossbite“, “maxillary expansion“, “palatal expansion“. Results: 31 publications were analyzed on the subject of posterior crossbite and maxillary expansion methods. Conclusions. The following methods of maxillary expansion can be distinguished: slow or rapid maxillary expansion, surgically assisted rapid palatal expansion and mini-implant assisted rapid palatal expansion. Method selection depends on patient’s age and skeletal maturity. The most important factor is midpalatal suture ossification level. Keywords: posterior crossbite, maxillary expansion, palatal expansion. https://doi.org/10.53453/ms.2021.06.19

Effects of Palatal Expansion with Torque Activation using a Transpalatal Arch: A Preliminary Single-Blind Randomized Clinical Trial.

Purpose The literature regarding the treatment of posterior crossbites using a transpalatal arch (TPA) is scarce. Moreover, there is only one clinical study on the correction of unilateral crossbites using torque activation. This is an important clinical issue; therefore, this study was conducted to show the effects of an active Goshgarian TPA in correcting nonfunctional single-tooth unilateral crossbite. Methods The present single-blind, randomized clinical trial examined 60 observations on 30 individuals with nonfunctional single-tooth unilateral crossbites in the first permanent molar area. Patients were randomly divided into two groups of “symmetric expansion” [control] and “expansion + torque activation” using Goshgarian TPAs [experimental]. The palatal arch was expanded at a rate of 2 mm/month, for 2–8 months. The average treatment durations were 157.9 and 117.1 days, respectively, for the control and experimental groups. Dentoskeletal alterations were assessed on dental records, posteroanterior frontal cephalographs, and occlusal radiographs taken before and after treatment. Changes induced by treatments in each group and differences between changes in both groups were analyzed statistically (α = 0.05). Results The treatment duration was significantly shorter in the experimental group (P < 0.05). The extent of dental displacement on the crossbite side was significant no matter what treatment was applied (P < 0.001); no between-group difference was detected (P > 0.05). Both treatments tilted the teeth in crossbite (P < 0.001) without any between-group difference (P > 0.05). The noncrossbite molar was displaced in the control group, whereas this did not occur in the experimental group (between-group P < 0.001). Conclusions The Goshgarian TPA can be used with torque activation in order to deliver a more effective and faster correction of nonfunctional single-tooth unilateral crossbites with more favorable clinical results.

Three-Dimensional Prospective Evaluation of Piezocision-Assisted and Conventional Rapid Maxillary Expansion: A Controlled Clinical Trial.

BACKGROUND:Piezocision-assisted orthodontics (PAO) is considered one of the modern techniques aiming at reducing the treatment time and overcoming some limitations of orthodontic treatment. The use of piezocision as an adjunct in the treatment of posterior crossbite is limited, so additional research in this area is required.AIM:To three-dimensionally compare the skeletal and dental effects produced by piezocision-assisted rapid maxillary expansion (PARME) and conventional rapid maxillary expansion (RME) using cone beam computed tomography (CBCT).MATERIALS AND METHODS:This prospective controlled study comprised 14 consecutive non-syndromic patients with posterior crossbite. In 7 patients (mean age = 16.1 ± 0.3 years), PARME was used to correct the crossbite; whereas in the remaining 7 (mean age = 15.9 ± 0.5 years), RME was done. Cone beam computed tomography (CBCT) scans were performed before expansion (T1) and 3 months later after expansion (T2) to compare the skeletal and dental effects produced by the two expansion techniques. Transverse skeletal, dentolinear, and dentoangular variables at the level of maxillary first and second premolars and maxillary first molars were measured and compared within and between groups using the appropriate statistical test.RESULTS:For the transverse skeletal variables, PARME showed a non-significant increase; whereas, RME showed a significant increase. Regarding the dentolinear measurements, a significant increase in coronal widths and an insignificant increase in apical widths was seen in PARME, whereas, the RME showed a non-significant increase for both coronal and apical widths. Non-significant decreases (protrusion of teeth) in the dentoangular measurements were seen in both groups. Between-group comparisons showed a non-significant difference except for the dentolinear coronal widths.CONCLUSION:PARME is effective in treating posterior crossbite. Because of the more dental expansion produced by PARME as compared to the conventional RME, PARME should be limited only to mild or moderate not severe forms of palatal constriction. The available evidence regarding the effectiveness of corticotomy- and/or piezocision-assisted maxillary expansion for correction of posterior crossbite is limited and inadequate.

Retention period after treatment of posterior crossbite with maxillary expansion: a systematic review.

ABSTRACTOBJECTIVE: The aim of this systematic review was to evaluate the duration of the retention period in growing patients undergoing maxillary expansion and its relation with posterior crossbite stability. METHODS: Search strategies were executed for electronic databases Cochrane Library, Web of Science, PubMed and Scopus, which were completed on January 15, 2016. The inclusion criteria included randomized, prospective or retrospective controlled trials in growing subjects with posterior crossbite; treated with maxillary expanders; retention phase after expansion; post-retention phase of at least 6 months. The exclusion criteria were anterior crossbite, craniofacial anomalies, surgery or another orthodontic intervention; case reports; author’s opinions articles, thesis, literature reviews and systematic reviews. The risk of bias of selected articles was assessed with Cochrane risk of bias tool for RCTs and Downs and Black checklist for non-RCTs.RESULTS: A total of 156 titles/abstracts was retrieved, 44 full-texts were examined, and 6 articles were selected and assessed for their methodological quality. The retention period after maxillary expansion ranged between 4 weeks and 16 months. Fixed (acrylic plate, Haas, Hyrax and quad-helix) or removable (Hawley and Hawley expander) appliances were used for retention.CONCLUSIONS: Six months of retention with either fixed or removable appliances seem to be enough to avoid relapse or to guarantee minimal changes in a short-term follow-up.

Changes in the masticatory cycle after treatment of posterior crossbite in children aged 4 to 5 years

The aim of this study was to analyze the dynamics of the masticatory cycle after occlusal adjustment through coronoplasty on deciduous teeth (selective grinding) and composite resin occlusal guidance for posterior crossbite correction. Nineteen children, aged 4 to 5 years, with functional posterior crossbites diagnosed at their clinical examinations, were selected. Analyses of masticatory cycles, including lateral excursive movements, were performed before and after treatment by using kinesiographic examinations in the 3 reference planes (frontal, horizontal, and sagittal). The examinations were done during bubble-gum chewing. The data were submitted to sign, Mann-Whitney, and paired t tests concerning the variables: left maximum lateral movement, right maximum lateral movement, total lateral movement (LM), vertical movement (VM), anteroposterior maximum movement, maximum lateral movement (MLM), and total maximum lateral movement (TMLM). The treatment produced increased TMLM, a significant increase of the MLM opposite the crossbite, no statistically significant difference of the crossbite side, and a significant decrease of LM. Left crossbite children showed significant decreases in the LM after treatment; right crossbite children showed significant increases in VM after treatment. Functional crossbite treatment with selective adjustment and occlusal guiding changed masticatory cycle patterns, producing larger horizontal and vertical planes. The cycles became more symmetric in the frontal plane, increasing the tendency of bilateral alternate mastication.

Traitements interceptifs (6-10 ans) des dysmorphies transversales : l'articulé croisé postérieur

By means of a review of the literature, the authors argue the case for early treatment of posterior cross bites. They outline the particularities and advantages of various therapeutic techniques including grinding down the interfering cusps of deciduous canines and palatal expansion in the mixed dentition.

Midpalatal suture opening during functional posterior cross-bite correction

The purpose of this study was to determine whether opening of the midpalatal suture occurs during treatment of posterior cross-bites by means of a Porter or W appliance. In eight of the ten cases treated there was radiographic evidence of midpalatal suture opening. Posterior cross-bite correction with a Porter or W appliance may occur either by a combination of midpalatal suture opening and buccal tipping of posterior teeth or by buccal tipping alone.