Anterior Cross Bite - Overview, Effect & Treatment

Abstract

Anterior cross bite is relatively a common presentation in the primary and mixed dentition stage. It is a malocclusion that takes place for various reasons , leads to major problems and may be fixed using various methods. If left untreated, it can lead to a host of problems and may complicate future orthodontic treatment. One of the major difficulties in young chilfren is treatment compliance. In most cases, poor compliance is due to the unacceptability of removable appliances used. Short span fixed appliances is also an option here.

INTRODUCTION

Anterior cross bite is defined as an abnormal reversed relationship of a tooth or teeth to the opposing teeth in the buccolingual (labiolingual) direction , also known as reverse articulation

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OCCURANCE

Many factors contribute towards the development of anterior crossbite , based on the nature of the crossbite into : skeletal, dental, functional and some more

Extensive caries : When there is extensive caries scenario in which there is structural loss of the upper teeth…automatically the lower teeth loose their stop and this eventually leads to a crossbite.

2. Trauma : a traumatic episode to a particular tooth or teeth which leads to change in the position of the tooth can lead to a crossbite that is a trauma.

3. Skeletal : arises due to either genetic or hereditary influence or discrepancy in the size of the maxilla and mandible.

4. Dental : here 1 or 2 teeth are often involved, and the affected tooth (teeth) are either upright or retroclined without any significant maxilla mandible (upper and lower jaw) discrepancy.

5. Functional : here a premature contact between opposing tooth/teeth could result in the deflection of the mandible to the sides or front and this leads to the development of psuedoclass III.

SIDEFFECTS

It may give rise to enamel wear mainly to the incisal edge (tip of tooth) due to heavy contact between the opposing teeth.

It can also affect periodontal health and this could lead to the gingival recession with thinning of alveolar bone and mobility of the opposing mandibular teeth.

Functional cross bite due to premature contact could lead to a possible jaw deviation and temporomandibular pain and dysfunction.

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TREATMENT

Many treatment modalities ranging from simple to complex means are available to correct anterior crossbite.

Some use removable appliances and others fixed ones.

An appropriate method depends on etiology and patient’s age and compliance, eruption status of teeth, space availability and treatment affordability and success.

1. A simple method such as tongue blade or icecream sticks (wooden) can be used in early stages where the teeth/tooth are still erupting.

2. Appliances such as catlan’s appliance and removable appliances with z sring (s) or expansion screw or microscrew(s) are often used to correct anterior cross bite related to dental factors in pre adolescent age group.

3. Crossbite of skeletal origin often requires complex methods such as rapid maxillary expansion and frankel III appliances. Occasionally, use of extraoral devices such as face mask and chincup may be necessary too.