Unilateral Posterior Crossbite Research Articles

Posterior crossbite corrections in the early mixed dentition with quad helix or rapid maxillary expander: a cost-effectiveness analysis of a randomized controlled trial.

Unilateral posterior crossbite is a common malocclusion, and early treatment is recommended to enable normal growth. There are several possibilities regarding choice of appliances used for correcting this malocclusion; however, when treatment is financed by public funds the decision needs to be based not only on the effects but also on the effect in relation to the costs. The aim was to perform a cost-effectiveness analysis comparing quad helix (QH) and rapid maxillary expanders (RME; hyrax-type) in children in the early mixed dentition. Seventy-two patients were randomized to treatment with either QH or RME, at two different centres. Data were collected from the patient's medical records regarding success rate, number of visits, total treatment time, emergency visits, and so forth, together with answers from patient questionnaires concerning absence from school and use of analgesics. A cost-effectiveness analysis with both an intention-to-treat (ITT) and a per-protocol approach was performed, as well as a deterministic sensitivity analysis. The success rate, one year after the completion of the expansion, was equal between groups according to the ITT approach. From a healthcare perspective, the mean cost difference between RME and QH was €32.05 in favour of QH (P = 0.583; NS). From a societal perspective, the mean cost difference was €32.61 in favour of QH (P = 0.742; NS). The total appliance cost alone was higher in the RME group €202.67 resp. €155.58 in the QH group (P = 0.001). The probability of RME having a higher cost was 71% from a healthcare perspective and 62.7% from a societal perspective. The total treatment time was 97 days longer in the QH group. In the deterministic sensitivity analysis, when using a higher valuation of the children's educational loss, the QH becomes €58 more costly than the RME. There was a statistically significant difference in chair time and visits between centres (P < 0.001). The difference in costs between RME and QH is not statistically significant, however, there is a slightly higher probability that RME is more expensive than QH with a mean cost of an additional €32 per patient from a healthcare perspective. Different work procedures at different centres indicate that logistics around the patient's treatment is a more important aspect than appliance used to decrease the number of visits and save chair time and thereby also costs.

Skeletal effects of posterior crossbite treatment with either quad helix or rapid maxillary expansion: a randomized controlled trial with 1-year follow-up

ABSTRACT Objectives To assess skeletal and dental effects and evaluate possible side effects of maxillary expansion with two different appliances, directly after expansion and 1 year postexpansion. Materials and Methods Forty-two patients with unilateral posterior crossbite (mean 9.5 ± 0.9 years) were randomized to either rapid maxillary expansion (RME) banded on the deciduous second molars and bonded to the primary canines or slow expansion with quad helix (QH) on the permanent first molars. Cone-beam computed tomography records were taken at baseline, directly after correction of the posterior crossbite and at follow-up 1 year after expansion. Results All patients were analyzed. RME opened the midpalatal suture more anteriorly and inferiorly (mean 4.1 mm) and less posteriorly and superiorly (mean 1.0 mm). No effect on midpalatal suture could be shown in the QH group after expansion, P &amp;lt; .001. Buccal bone width had significantly decreased (P &amp;lt; .001) in the QH group compared with the RME group. Buccal fenestrations and root resorption on the left first molar had a higher prevalence directly after expansion finished in the QH group (P = .0086, P = .013) but were not significant at 1-year follow-up (P = .11, P = .22). Conclusions Opening of the suture with RME was more anterior and inferior, and the QH did not open the midpalatal suture at all. More buccal bone loss and fenestrations were seen on the permanent first molar in patients treated with conventional QH than RME anchored to deciduous teeth.

EMG ACTIVITY OF MUSCLES OF THE CRANIOMANDIBULAR SYSTEM IN SUBJECTS WITH NARROWING UPPER JAW AND POSTERIOR CROSSBITE

Posterior crossbite in children and adolescents has been linked to asymmetrical function and performance of the masticatory muscles. Electromyography (EMG) serves as an objective and widely applicable evidence-based method for diagnosing muscle function. The aim of our study was to analyze electromyographic (EMG) activity of muscles of the craniomandibular system in subjects with a narrowing upper jaw and unilateral posterior crossbite. Material and methods. The first (study) group consisted of 18 subjects with narrow maxilla and unilateral posterior crossbite. 20 age-matched children with normal occlusion were included in the control group. The average age of subjects in the study group was 8.4±1.4 years, in the control group – 8.8±1.6 years. The exclusion criteria of the study were as follows: previous or active orthodontic treatment, clefts, traumas in the maxillofacial region, and general diseases. EMG activity of the anterior temporal, masseter, sternocleidomastoid (SCM), orbicularis oris, and mentalis muscles on both sides (left and right) was recorded during two 30-second tests: maximum voluntary clenching and swallowing a sip of water. Maximum voluntary clenching was performed in the intercuspal position. EMG data were processed using Neurotech's Synapsis software. EMG activity for each muscle was estimated by the maximum amplitude of the muscle contractions (μV). Results. EMG activity in children with narrowing upper jaw and unilateral posterior crossbite of anterior temporal, masseter, and sternocleidomastoid muscles was asymmetrical and differed between the left and right sides. Higher bioelectrical muscle activity was found on the crossbite side for the masseter and anterior temporalis muscle, and on the opposite side – for sternocleidomastoid muscles. Values of maximum amplitude of sternocleidomastoid muscles were higher in the study group than in the control group without significant difference. There was a statistically significant difference in EMG activity of mentalis and orbicularis oris muscles between the two groups of children (p&lt;0.05). Values of EMG activity of mentalis and orbicularis oris were higher in the study group.

Three-dimensional analysis of mandibular morphology asymmetry and temporomandibular joint position in patients with unilateral Brodie bite.

Previous studies have shown unilateral posterior crossbite is associated with mandibular asymmetry in morphology and position. However, it remains unclear whether unilateral Brodie bite plays a similar role in mandibular development. Therefore, this study aims to investigate the morphological and positional symmetry of mandibles in patients with unilateral Brodie bite by three-dimensional anaylsis. Fourteen patients with unilateral Brodie bite (mean age 18.43 ± 4.24 years) and fourteen sex- and age-matched patients with normal occlusion (mean age 18.07 ± 5.48 years) underwent cone-beam computed tomography (CBCT) scans. 3D surface mesh models of their mandibles were established using Mimics Research 19.0. The surface matching percentage was compared between the original and mirrored mandible by Geomagic Control X software. Furthermore, the dimension and position of the temporomandibular joint (TMJ) were determined for both groups using InVivoDental 5.0. For surface-to-surface deviation analysis, the percentage of mismatch in patients with unilateral Brodie bite was significantly higher than the control group at ±0.50 mm, ±0.75 mm, and ±1.00 mm tolerance (P < .001). In patients with unilateral Brodie syndrome, the condyles on the scissors-bite side showed a significantly more anterior position (P = .03), greater medial inclination (P < .01), and larger posterior TMJ space (P = .01) than the non-scissors-bite side. Patients with unilateral Brodie bite exhibit a more asymmetrical mandibular morphology, with a greater anterior condylar position and posterior joint space on the scissors-bite side, indicating that early diagnosis and treatment may be necessary for patients with unilateral Brodie bite.

Exploring the potential of rapid maxillary expansion and masticatory muscle activity in unilateral posterior crossbite

Exploring the potential of rapid maxillary expansion and masticatory muscle activity in unilateral posterior crossbite

Challenges of a two-phase orthodontic treatment of a mandibular lateral incisor-canine transposition and a maxillary palatally displaced canine: A case report.

The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treatment of a patient presenting with a dental eruption pattern anomaly. A 10-year-old boy was presented with no complaints for a routine orthodontic evaluation during mixed dentition. The patient was diagnosed with a skeletal Class I malocclusion with unilateral posterior crossbite, incomplete mandibular lateral incisor-canine transposition and a unilateral maxillary ectopic canine. Phase 1 started with rapid maxillary expansion to correct maxillary constriction and the ectopic eruption of the right maxillary canine. In the mandibular arch, phase 1 included the extraction of the left primary lateral incisor and canine, alignment of the left permanent lateral incisor and orthodontic traction of the left permanent canine. The duration of phase 1 was 14 months. Phase 2 involved a comprehensive course of orthodontic treatment and started when the patient was aged 13 years. This phase lasted 18 months. An adequate dental occlusion was obtained, and the treatment results were stable after an 18-month follow-up. In this case, the early diagnosis of the dental anomalies was valuable as it allowed an early intervention to be undertaken, which resulted in overall treatment simplification and potentially minimised the adverse effects. This case report reinforces the importance of a careful follow-up during mixed dentition.

Analysis of mandibular asymmetry in adolescent and adult patients with unilateral posterior crossbite on cone-beam computed tomography

This study aimed to evaluate mandibular asymmetry in unilateral posterior crossbite (UPXB) patients and compare the asymmetry between adolescents and adults with UPXB. This study included and analyzed cone-beam computed tomography scans of 125 subjects. The subjects were divided into a UPXB group and a control group according to the presence or absence of UPXB, and each group included adolescent patients (aged 10-15 years) and adult patients (aged 20-40 years). Linear, angular, and volumetric measurements were obtained to evaluate the asymmetries of the mandibles. Both adolescent and adult patients in the UPXB group presented asymmetries in condylar unit length, ramal height, body length, and mediolateral ramal inclination (P<0.05). Adult patients with UPXB showed greater asymmetries than adolescents. Differences with condylar unit length, condylar unit width, ramal height, condylar unit volume, and hemimandibular volume were significantly greater in adult UPXB patients than adolescent UPXB patients (P<0.05). The worsening of mandibular asymmetries in UPXB adults suggests that asymmetry in UPXB patients may progress over time; therefore, early treatment should be considered for UPXB adolescent patients. Further studies are still needed to evaluate the effectiveness of early treatment.

Orthodontic Management of Anterior and Unilateral Posterior Crossbite: A Case Report

Crossbite refers to abnormal labiolingual and buccolingual relations between the opposing teeth. This results in the imbalanced facial appearance of the patient causing varied degrees of distress based on the individual's values and self-esteem. The management of skeletal class III malocclusion with anterior and posterior crossbite can be challenging. This case report describes a case of skeletal class III malocclusion complicated with an anterior, and unilateral posterior crossbite, and severe crowding which was managed satisfactorily with a fixed orthodontic appliance. The proper clinical examination, diagnosis, problem list, and formulation of the treatment plan are of utmost importance for the proper management of the case. The diagnosis can be done through proper history, clinical examination, an orthopantomogram, and a lateral cephalogram. The patient's grin was transformed from a non-consonant to a consonant smile, and the profile was transformed from slightly concave to straight.

Three-dimensional evaluation of the temporomandibular joints after unilateral surgically assisted rapid maxillary expansion in adults: A preliminary retrospective study.

Unilateral surgically assisted rapid maxillary expansion (U-SARME) is a successful method for correction of true unilateral posterior crossbite (TUPC). This retrospective preliminary study aimed to evaluate the position and morphology of condyles in TUPC cases and the effects of U-SARME on condyle with the help of cone beam computed tomography (CBCT). Fifteen patients (mean age: 18.69 ± 1.59 years) who were diagnosed as TUPC and undergone U-SARME were selected. Preoperative (T0) and after 6-month retention (T1) DICOM data of CBCT images were evaluated with MIMICs version 19.0 software. Condylar morphology (medio-lateral and antero-posterior dimensions) and position (anterior, posterior, medial and lateral joint spaces, frontal/axial axis angles, the ratio of posterior to anterior joint space and the percentage of posterior to anterior joint space) were evaluated. Student's t-test was used for intergroup (crossbite, normal) comparisons. Paired-samples t-test was used for intra-group comparisons (p = .05). There were no positional or dimensional asymmetry of the condyles between crossbite and normal sides initially and after expansion. Regarding T0-T1 changes, while significant increase was determined in medial (0.3 ± 0.29 mm; p = .001) and superior (0.39 ± 0.7 mm; p = .045) joint spaces on crossbite side, posterior (0.79 ± 0.99 mm; p = .008), superior (0.5 ± 0.79 mm; p = .029) and lateral joint spaces (0.31 ± 0.54 mm; p = .042) presented significant increases on normal side. However, no significant changes were found between crossbite and normal sides at T0 and T1. Condyles were symmetrical in true unilateral posterior crossbite cases and the symmetry were not disrupted following U-SARME.

Cross-Bite and Oral-Health-Related Quality of Life (OHRQoL) in Preadolescents Aged 11 to 14 Years Old: A Pilot Case-Control Study.

Malocclusions have a negative impact on oral-health-related quality of life (OHRQoL). Posterior cross-bite is one of the most prevalent malocclusions in the preadolescent population. This study investigated the influence of posterior cross-bites (unilateral or bilateral) on OHRQoL in an 11- to 14-year-old population. A pilot case-control study was carried out at the Dental Clinic of the University of Salamanca between 2021 and 2023. A consecutive sample of 120 preadolescent patients aged 11 to 14 years old was recruited. Three groups were analyzed: a control group (no posterior cross-bite) (n = 40), a group with unilateral posterior cross-bite (n = 40), and a group with bilateral posterior cross-bite (n = 40). To analyze the OHRQoL, the Spanish version of the Child Perception Questionnaire (CPQ-Esp11-14) was used. The mean age of the sample was 12.2 years old (±0.96 years). The group of patients with a bilateral posterior cross-bite was shown to have higher scores in all dimensions of the CPQ-Esp11-14, as well as a higher total score. Sex only influenced the oral symptom dimension of the CPQ-Esp11-14 questionnaire; in this dimension, the girls described a greater impact. Age did not influence OHRQoL. The presence of a posterior cross-bite had a negative impact on OHRQoL in the preadolescent population that was studied.

An Evaluation of the Ramus Mandibular Asymmetry on the Panoramic Radiography

This study is intended to focus on the evaluation of posterior vertical mandibular asymmetry by calculating the mandibular asymmetry index on the panoramic radiography in different types of malocclusions, considering the sexual dimorphism in children and adolescent patients and performing a comparative analysis between these groups. In this context, a cross-sectional study was conducted for a group of 214 patients (134 females and 80 males with a mean age of 9.5 ± 2 years). The asymmetry index was calculated for each patient according to the Habets method. The results were analyzed by using the independent Student t-test, ANOVA and Mann–Whitney U-test at the 95% confidence level (p &lt; 0.05). The results of the analyses showed a statistically significant difference between males and females at the level of the condylar index (p = 0.023) and a significant difference in the unilateral posterior crossbite in the Mann–Whitney U test (p = 0.01). No statistically significant differences were found between males and females in the index of the mandibular ramus and condyle-plus-ramus. The highest value of the asymmetry index was recorded at the level of the condyle. We found higher values of asymmetry in Angle Class I malocclusions in all groups and in Class II/1 in the group of females.

Orthosurgical approach of a skeletal class III malocclusion with mandibular laterognathia: a case report.

Skeletal class III malocclusion is characterized by an evident disharmony and discrepancy between the maxilla and mandible, affecting facial appearance and masticatory function. Usually, the association of transversal and vertical anomalies along with the anteroposterior problem makes the orthodontist's job perceived as a challenge. The ortho-surgical approach can be considered as an efficient alternative for the treatment of skeletal class III malocclusion, and it requires an interdisciplinary relationship between the orthodontist and a maxillofacial surgeon. This case report presents a 25-year-old female patient who consulted with a chief complaint of unsatisfactory facial esthetics. The clinical examination revealed a skeletal class III mainly due to maxilla hypoplasia accompanied with mandibular laterognathism, causing a unilateral posterior crossbite. The patient was treated with the ortho-surgical approach. The treatment objectives were achieved, providing a stable class I occlusion with an acceptable overjet and overbite, coordinated midlines, and a satisfactory facial profile with an excellent esthetic balance between the hard and soft tissue.

Evaluation of dental and skeletal effects of the asymmetric rapid maxillary expansion appliance: A three-dimensional finite element study.

Transverse maxillary deficiency is one of the most common skeletal anomalies. The incidence of posterior crossbite caused by maxillary deficiency is between 2.7% and 23.3%. Unilateral posterior crossbite is more common than bilateral crossbite. The most common treatment for skeletal posterior crossbite is rapid maxillary expansion (RME), in which the base of the maxillary bone is expanded by separating the midpalatal suture. This study compares the biomechanical effects of three different RME appliances, especially the effects on the midline, and evaluates the usability of the modified asymmetric RME (ARME) appliance for treating unilateral crossbites. Three scenarios were created with skull models using three different appliances: (1) conventional-bonded RME appliance; (2) full-cap splint RME appliance, with all teeth covered with acrylic; and (3) ARME, with all teeth on the right side and premolars and molars on the left side covered with acrylic. The finite element method was used to assess stress levels and displacements in all models after applying a 5-mm horizontal displacement to the RME screw. The lateral transverse movement of the first molars was greater with the conventional RME appliance than with the full-cap splint RME appliance. The lateral transverse movement of the first molar was greater on the left than on the right side with the ARME. The lateral transverse movement of the central incisors was greater with the full-cap splint RME appliance than with the conventional RME appliance. The lateral transverse movement of the central incisor was greater on the right than on the left side with the ARME. Asymmetrical RME appliance increases unilateral expansion compared to other appliances. Therefore, it should be used in cases of unilateral posterior crossbite. This appliance can also successfully treat posterior crossbite with upper midline deviation, since it corrects the shifted midline.

Evaluation of Masticatory Muscles in Adult Patients with Maxillary Hypoplasia Treated with Surgically Assisted Rapid Maxillary Expansion (SARME): A Retrospective Study.

Aim: The aim of the present study was to investigate modifications in electromyographic activity of temporal and masseter muscles before and after surgically assisted rapid maxillary expansion (SARME) in adult subjects. Materials and Methods: Data from 20 patients with unilateral posterior crossbite were selected retrospectively from the Orthodontics Department of the University of Genoa and the Department of Biomedical Surgical and Dental Sciences of the University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico Milan. Inclusion criteria were set as skeletal class I; adult patients (age > 18); good general health; patients with a transverse maxillary deficiency with unilateral posterior crossbite and maxillary constriction ≥ 5 mm; Superficial electromyographic (EMG) examinations at T0 and T1. Exclusion criteria were smoking, metabolic bone diseases (e.g., hyperparathyroidism, vitamin C deficiency), chronic use of corticoids before or during treatment, parafunctional habits (e.g., bruxism), and temporomandibular joint dysfunction. The Shapiro−Wilk test was performed to check whether the data were normally distributed. Differences for each variable before and after SARME were analyzed with a paired t-test (p < 0.05). Results: The statistical analysis demonstrated no statistically significant differences between the EMG values taken before and after SARME regarding the standardized electrical activity of the masticatory muscles (masseter and anterior temporalis (p > 0.05)). Conclusions: Considering the specific conditions of this study, it can be concluded that SARME did not alter the EMG activity of the masseter and temporal muscles. The present study has shown that the masticatory musculature evaluated after approximately 8 months of therapy can adapt well to SARME.

Can malocclusion among children impact their oral health-related quality of life? parents' perspective.

Malocclusion can negatively impact the quality of life of children. Therefore, this study assesses the impact of proxy-reported malocclusion and oral health-related quality of life among children in Riyadh, Saudi Arabia, from the parents or guardians' perspectives. A self-administered electronic questionnaire was used to assess the correlation between proxy-reported malocclusion conditions during the early mixed dentition stage (children age 6-12 years) and oral health-related quality of life using the OHIP-14 measure. All collected data were analyzed using SPSS. Among the 353 participants in the study, anterior open-bite was the most common proxy-reported malocclusion with a prevalence of 19%, followed by unilateral posterior cross bite (13.3%). Furthermore, 31% reported that their children sometimes experienced negative impacts on quality of life from malocclusions. The results also show that OHIP-14 scores were significantly associated with all proxy-reported malocclusion (p < 0.05). The highest OHIP-14 score was found to be significantly associated with the presence of deep-bite from parents' or guardians' perspective. The presence of some proxy-assessed malocclusion was associated with negative impacts on children's oral health-related quality of life. This is very important to consider when assessing the need for orthodontic intervention, especially at this stage as this age is critical in building a child's confidence and self-esteem.

Abordagem interdisciplinar no tratamento da macroglossia na síndrome de Beckwith-Wiedemann: relato de caso

ABSTRACT This study aims to report the interdisciplinary management of macroglossia in a Beckwith-Wiedemann syndrome patient during ten years. Clinical follow-up started by the Oral and Maxillofacial Surgery team, followed by Speech Therapy due to feeding difficulties. After clinical and instrumental evaluation, at 8 months old, the speech therapy intervention was indicated, focusing on oropharyngeal dysphagia and orofacial myofunctional therapy. At 1 year and 11 months, no signs of swallowing alteration in the pharyngeal phase and improvement in the posture of the lips and tongue were found. At the age of 3, stimulation to remove oral habits and train masticatory function were initiated. Orthodontic treatment to correct anterior open bite and unilateral posterior crossbite started at age 6. At 7 years and 5 months, there was stability in the nasal breathing mode and adequacy of resting posture of lips and tongue. At the age of 9, due to relapse of the occlusal alterations, surgical reduction of the tongue was indicated, followed by orofacial myofunctional therapy, restarted at the age of 9 years and 3 months. The result was the correction of the posture of the tongue during swallowing and speech adequacy. The association of treatments involving Speech Therapy, Orthodontics and Oral and Maxillofacial Surgery was considered effective in the management of the macroglossia. It resulted in the adequacy and equilibrium of orofacial functions.

Three-dimensional quantitative analysis of dental and skeletal characteristics of skeletal Class I unilateral posterior crossbite in adults.

To study the dentoskeletal characteristics and the degree of compensations in skeletal Class I adults with unilateral posterior crossbite (UPCB). A sample of 40 adults was chosen for this cross-sectional study. 20 skeletal Class I adults with UPCB (mean age: 22.20±2.88years), were compared to 20 skeletal Class I adults with normal occlusion (mean age: 27.56 ± 5.76years). The respective dentoskeletal measurements were made on cross-sectional images from cone-beam computed tomography scans. Skeletally, both groups showed significant differences (P < 0.05) in mandibular corpus length and menton deviation with the UPCB group showing the greatest displacement. Maxillomandibular vertical asymmetry and condylar positional asymmetry were not significant in both groups (P > 0.05). For dental variables on the second premolar and first molar, the UPCB group showed greater linear and angular differences when compared to the control group (P < 0.05). On the crossbite side, maxillary posterior teeth were more buccally inclined, and mandibular posterior teeth were more lingually inclined. However, on the non-crossbite side, both maxillary and mandibular posterior teeth were lingually inclined. Adults with UPCB showed distinct transverse dentoskeletal asymmetry. No asymmetry was found in the condylar position and the mandibular height in UPCB adults.

Condylar Asymmetry in Children with Unilateral Posterior Crossbite Malocclusion: A Comparative Cross-Sectional Study.

Unilateral posterior crossbite (UXB) is a common, severely asymmetric malocclusion, characterized by maxillary hypoplasia and masticatory dysfunction. The aim of this research is to evaluate the asymmetry of mandibular condyles and rami in children with UXB. This comparative cross-sectional study included 33 children with UXB (girls = 15, boys = 18; mean age ± SD = 8.0 ± 1.3 years.months]) and 33 age- and gender-matched controls (girls = 15, boys = 18; mean age ± SD = 8.4 ± 1.3 years.months]). Pre-treatment OPGs were analyzed by comparing the height of condyles and rami between the sides using the method by Habets et al. (1988); the result was considered significant if the degree of asymmetry was &gt;6%. Children with UXB showed a significantly increased asymmetry of mandibular condyles (mean ± SD = 10.7% ± 9, p &lt; 0.001), but not of rami (mean ± SD = 1.9% ± 2.3), compared to controls. The rami did not show significant asymmetry in either group. The presence of an increased condylar asymmetry index in a developing patient with unilateral posterior crossbite is a sign of altered skeletal growth and should be considered in the diagnostic process and treatment plan.

Successful traction of a mesially 90° dilacerated root of impacted maxillary canine: A case report

Background: Impacted maxillary anterior teeth are a problem that has a significant impact on the aesthetics of the smile, dental arches, and occlusion. Teeth that have higher tendencies to get impacted are third molars, maxillary central incisors, maxillary canines, and mandibular premolars. Impacted teeth with severe root dilacerations are usually extracted surgically, then the space will be closed by orthodontic treatment or using a prosthesis. Purpose: This study aims to report the successful orthodontic traction of mesially 90° dilacerated root of impacted maxillary canine. Case: A 15-year-old female patient with the chief complaint of an unerupted left maxillary canine. Intraoral examination showed a class I molar relationship on both sides, a unilateral crossbite on the right side, 8 mm spacing between the maxillary left lateral incisor and the premolar. Also, mild crowding was found on both upper and lower anterior segments. CBCT results showed a left maxillary canine was palatally semi-vertical impacted and had a mesially 90° dilacerated root. A significant stress concentration occurred at the middle and apical of the dilacerated root apex when exposed to orthodontic force; this tends to be a higher potential for resorption. Case Management: The impacted dilacerated canine was successfully moved to the proper position by combining crown exposure surgery, orthodontic traction using continuous light force, and gingivectomy. Furthermore, traction was held using a gold chain combined with an elastic thread tied initially to a modified stainless-steel main archwire; this was followed by piggyback tandem wire and a vertical 3/16” light elastic traction. Conclusion: The patient showed successful traction of the canine in less than six months. In addition, the unilateral posterior crossbite was corrected and functional occlusion was achieved. That canine showed good orthodontic and periodontal stability at one-year follow-up, without any evidence of root resorption.

Advantages of Interceptive Orthodontic Treatment; Rapid Maxillary Expansion in Children with Malocclusion Resulting from Mouth Breathing Habits

Background: One of the causes of malocclusion in developing children is the practice of mouth breathing. Morphological disturbances may occur during the growth phase in children with chronic mouth breathing. This resulting in the unfavorable development of dentofacial and craniofacial complexes. Mouth breathing in children as a condition has come to the attention of health care professionals. Malocclusion incidence will be decreased and eventually eliminated with the early identification and treatment of these poor oral habits. Purpose: The study determines the benefits of interceptive orthodontics Rapid Maxillary Expansion treatment in children with malocclusion caused by the habit of mouth breathing. Methods: Data were gathered by searching and analyzing literature from electronic databases PubMed, Wiley, and Science Direct in the 2012 and 2022 publication period. Interceptive orthodontics; rapid maxillary expansion; mouth breathing; malocclusion and children keywords were used to conduct the systematic search of the data. Results: One of the most frequent malocclusions is caused by the practice of mouth breathing which narrows the maxillary arch. Some of the characteristic features are decreased distance between nasal cavity’s lateral walls, bilateral or unilateral posterior crossbite, crowding of the anterior teeth, and deep palate.