Lecture 7 Anterior & Posterior Crossbites (6 Per Page) [Compatibility Mode]

7/28/2019 Lecture 7 Anterior & Posterior Crossbites (6 Per Page) [Compatibility Mode]

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LE CT U R E 7

IN G R ID R E E D D D S , M S

Anterior and PosteriorCrossbites

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D E P A R T M E N T O F O R T H O D O N T ICS &D E N T O F A CIA L O R T H O P E D ICS

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Anterior Crossbite

y Dental one or two teeth

{ Abnormal axial inclination

{ Retained primary tooth

{ Crowding

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y Skeletal - Class III ANB


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Anterior Crossbite - Dental8

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Anterior Crossbite - Skeletal9

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Anterior Crossbite - Skeletal10

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Treatment Dental anterior crossbite

y Popsicle stick

y Removable appliance with finger spring

y Fixed appliances

y Possible extraction of ad acent deciduous teeth

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Tongue blade12

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Hawley with finger spring14

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Hawley with finger spring

yAssess space available

y

Alginate impressiony Pour in yellow stone

y Fabricate Hawley with clasps and finger spring

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{ Bend finger spring so it unwinds in the direction it was wound

y Build up molars to clear occlusion

y Deliver appliance

yActivate spring every few weeks

y Self retaining

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Hawley with finger spring

yAssess space available

yAlginate impression

y Pour in yellow stone

y Fabricate Hawle with clas s and fin er s rin

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{ Bend finger spring so it unwinds in the direction it was wound

y Build up molars to clear occlusion

y Deliver appliance

yActivate spring every few weeks

y Self retaining

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Dental Anterior Crossbite18

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AN T ER I O R C R OS SB I TE

Case JH23

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8 years 0 months24

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Initial25

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8 years 4 months26

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Age 12 years

Anterior crossbite of lateral incisors

y Maxillary laterals usually erupt to the lingual ifinadequate space

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Retention of Anterior Crossbites

y Good overbite relationship

y Should be self retaining

y Tipping tooth forward vertical change in overbite

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Cleft Palate JB Start of Phase I33

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Initial34

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Initial35

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End of phase I36

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End of Phase 137

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Start of Phase II38

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Start of Phase II39

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Final Records40

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Final Records41

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Bilateral Cleft Palate43

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Cleft palate treatment sequence

TIME PROCEDURE

2-4 weeks Lip closure

12-18 mo nt hs Palate closure

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7-8 years Alignment of maxillary incisors, expansion of maxil la , aspreparation for alveolar graft

7-9 years Alveolar bone graft (before eruption of lateral incisor, ifpresent, or canine)

Adolescence Comprehensive orthodonticsLip /nose revision

Late adolescence Orthognathic surgery?

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Cleft palate orthodontic problems

y Problems from repair not cleft itself

{ Lip repair constriction across anterior of maxilla anteriorcrossbite

{ Palate repair constriction laterally posterior crossbite

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{ Maxillary incisors erupt rotated and in crossbite

{ Lateral incisor and/or canine in area of cleft missing orimpacted

{ Cleft area doesnt have bone for eruption alveolar graftneeded

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Early permanent dentition treatment

y Correct maxillary incisors

{ Rotations

{ Crossbite

{ Position

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y xpan max a

yAlveolar bone graft

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Unrepaired cleft - TG 1-24-0348

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TG 1-24-0349

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TG 1-24-03

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TG 7-25-0751

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TG 10-25-0852

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TG 10-25-0853

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TG 10-25-0855

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8/25/201057

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Orthognathic surgery - cleft palate patients

y Males > females

y Growth return of anterior and/or lateral crossbites{ Usually deficient maxillary growth

{

Normal mandibular growth

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SKELETAL

Posterior Crossbites61

DENTAL

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Posterior Crossbite

y Posterior crossbite position of maxillary molars

{ Bilateral maxillary lingual crossbite

{ Unilateral maxillary lingual crossbite

Asymmetric maxillary arch

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Normal maxilla

Asymmetric mandible

{ Maxillary buccal crossbite (Brodie Bite)

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Why does this crossbite exist?

y Bilateral maxillary palatal crossbite

{ Maxilla narrow - skeletal basis

{ Dental arch narrowed skeletal width correct

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Rapid Palatal Expander67

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Treatment palatal expander68

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Posterior Crossbites69

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Dental Posterior Crossbite71

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Oral habits disruptive to occlusion

y Thumb sucking

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Finger suckingy Tongue thrust

y Nail biting

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y Lip biting

y Lip sucking

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Thumb (finger) sucking - phases

Phase IBirth to 3 years

Normal , especially associated with weaning.Usually self eliminated.

Phase II3 to 6 or 7 years

3-4 years: mild displacement of primary teeth; normal lip &cheek pressure will restore teeth to usual position if sucking

stops

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er erup on o permanen ncsors: suc ng pers s s, s ophabit and start orthodontic treatment to correct toothdisplacement.Constricted maxilla: least likely to correct spontaneously

Phase III Thumb sucking may be a sign of psychological problemsTalk to child

Appliance to help child

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Thumb (finger sucking)75

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Effects of thumb sucking

y Tongue lowered to accommodate thumb

y

Cheek pressure{ Greatest at corners of mouth

{ More constriction at canines

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{ V- s ape pa ate

{ Lingual movement of maxillary molars

{ Mandibular molars unchanged

{ Anterior teeth and premaxilla can be moved

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Cheek

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Tongue

Malocclusion due to sucking habit

Lowerincisors

Lingualdisplacement

Upperincisors

Labialdisplacement

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ax ary arch

arrow

Interarchrelation

Anterior openbite

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Treatment79

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Crib

Reference80

Contemporary Orthodontics, 4th EditionContemporary Orthodontics, 4th Edition

William R. ProffitWilliam R. Proffit

Henry W. Fields J r.Henry W. Fields J r.

DavidM SarverDavidM Sarver

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..

Pages: 68, 147Pages: 68, 147--149, 175149, 175--176 ,224176 ,224--226, 244226, 244--248,437248,437--443,443,

559559--560, 622560, 622

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Lecture 7 Anterior & Posterior Crossbites (6 Per Page) [Compatibility Mode]