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CONTENTS
1. Definition 2. Etiology 3. Classification 4. Clinical Features 5. Diagnosis 6. Management
DEFINITION:
According to Graber:
1. Traumatic injury to primary dentition 1. Prolonged retention of primary tooth. that causes a lingual displacement of permanent tooth bud. Persistance of a deciduous tooth
2. Ectopic eruption of the permanent first molar. 3. Prolonged thumb or finger sucking. 4. Cleft palate cases.
Etiology of Anterior cross bite [II] Skeletal Causes 1. Genetic. 2. Due to deficient anterior growth of maxilla
1. Genetic. 2. Due to deficient lateral growth of maxilla. Eg. In cleft palate cases se Stimulation in mid palatal suture se Lateral maxillary growth
3. Excessive abnormal mandibular growth in 3. Excessive abnormal anteriorly. growth laterally. 4. Combination of both 2. & 3.
mandibular
2. Habitual mandible
forward to
positioning obtain
of
the
CLASSIFICATION
[I] Based on Location Cross bite
ANTERIOR CROSS BITE a. According to no. of teeth involved POSTERIOR CROSS BITE a. According to no. of teeth involved
Buccal Non-occlusion
Lingual Non-occlusion
Cross bite
Skeletal Crossbite
Dental Crossbite
Functional Crossbite
Clinical Features
Anterior cross bite
An abnormal labiolingual relationship (reverse overjet) between one or more maxilary and mandibular anterior teeth.
Segmental crossbite
Involve a segment of arch
posterior teeth occlude lingual to the buccal cusps of the mandibular teeth.
Palatal/Lingual Non-occlusion
Maxillary posterior occlude entirely on the
the
Anterior
crossbite
due
to
maxillary retrognathism.
4. Supernumerary teeth.
DIAGNOSIS
1. History 2. Clinical Examination 3. Study Models
4. Radiograph
1. Lateral cephalogram (for anterior cross bite) 2. PA view of cephalogram (for posterior cross bite)
[I] In primary [II] In mixed [III] In permanent [IV] In post dentition dentition dentition permanent dentition
Anterior cross bite should be treated at an early stage. Because (i) If a cross bite present in the deciduous dentition, it may manifest in the mixed & permanent dentition as well. (ii) If a simple anterior cross bite is not treated in early stage
It may progress into skeleton malocclusion that later need complicated orthodontic treatment or surgical treatment.
It is placed inside the mouth contacting the palatal aspect of the maxillary teeth.
Upon slight closure of jaw the opposing side of the stick come in contact with the labial aspect of the opposing mandibular tooth acts as a fulcrum. This is continued for 1-2 hours for about 2 weeks.
Drawbacks of using tongue blade Only effective till the clinical crown not completely erupted in the oral cavity. Used only if sufficient space is available for the correction. Patients cooperation is required.
- Used only in those cases where the cross bite is due to a palataly placed max incisors.
(Constructed at 450 angulations on the lower anterior teeth by acrylic or cast metal).
Prevent the posterior teeth from coming into contact If prolonged use Supra eruption of posterior teeth
Pre-treatment
Disadvantage Effective only when there is enough space for aligning the teeth.
During treatment
Post-treatment
[5] Face mask (or face mask along with RME) Indications
- Used to correct skeletal anterior cross bite (Anterior cross bite due to actual skeletal deficiency of the maxilla Protraction face mask or Reverse head gear
If maxilla is narrow
[III] IN PERMANENT DENTITION (In Adolescent & Adult) (1) Screw appliance
Mini screw Medium screw May be used to correct single tooth or segmental cross bite.
Adequate space is required to correct the anterior cross bite Otherwise results will be compromised
(4) R.M.E.
Hyrax screw
Welded to molar bands that are cemented to the maxillary permanent molars