Simplified Fixed Technique for Correction of Anterior Crossbite: A Case Series

ABSTRACT@#Anterior crossbites would normally require early intervention, especially when associated with mandibular displacements. The intervention would usually commence in children around the age of eight and nine, where treatment could be a challenge at this age. Therefore, a simple and quick treatment to this malocclusion would be desirable. This case series illustrates two cases of anterior crossbite with a functional shift that were successfully corrected using a simplified fixed technique, which involved a short-span nickel-titanium (Ni-Ti) aligning round archwire, composite resin and glass ionomer cement (GIC).

El quad-hélix, un aparato versátil / The quad-hélix, a versatile appliance

El quad-hélix (QH) es un aparato de expansión maxilar, fabricado con alambre de acero inoxidable soldado a bandas en molares, que dispone de espirales o hélices que aumentan la longitud de alambre del aparato, lo que lo hace muy elástico y aligera la magnitud de la fuerza sobre los dientes, es ampliamente usado tanto en dentición mixta como en permanente temprana, fácil de fabricar, higiénico y bien tolerado por los pacientes. Su principal acción es mover hacia vestibular los procesos dentoalveolares de la arcada maxilar, influyendo secundariamente en la expansión de la sutura palatina media en pacientes con dentición mixta o permanente temprana. El QH es muy práctico y tiene muchos usos y adaptaciones y se puede utilizar como auxiliar en el tratamiento de problemas de hábito de dedo o lengua, para abrir mordida, rotar y dar torque a molares permanentes o para mover sólo un diente en particular. En este artículo describimos una nueva aplicación del QH que consiste en la tracción, de dientes anteriores superiores permanentes retenidos, después del abordaje quirúrgico para localizarlos. También revisaremos las indicaciones, contraindicaciones, ventajas y desventajas del aparato QH soldado a bandas en molares así como su elaboración, variantes y forma de activación (AU)

The quad-helix (QH) is a maxillary expansion appliance, manufactured with stainless steel wire welded to bands in molars, which has spirals or helix to increase the length of wire of the device, which makes it very elastic and lightens the magnitude of the force on the teeth, is widely used both in mixed and in early permanent dentition, is easy to manufacture, hygienic and well tolerated by patients. Its major action is to move towards the dentoalveolar process of the maxillary arcade, secondarily influencing the expansion of the middle palatal suture in young patients with mixed or permanent early dentition. The QH is very practical and has many uses and adaptations as an aid in the treatment of problem of thumb sucking or tongue habit, to open bite, to rotate and torque permanent molars or to move only one particular tooth. In this article we describe a new application of the QH that consist of the traction or retained permanent upper teeth, after surgical approach to locate them. We will also review the indications, contraindications, advantages and disadvantages of the QH welded to molar bands, as well as its construction, variants and activation form (AU)

Camouflage Treatment of Skeletal Class III Malocclusion with Anterior Crossbite in Adults: A Case Series

In the current scenario, different treatment modalities exist when orthodontic camouflage needs to be done in patients with mildor moderate skeletal Class III malocclusions. Recent advances such as temporary anchorage devices increased the scope ofcamouflage treatment. This series of cases describes the non-surgical management of skeletal Class III malocclusion usingtreatment mechanics, which efficiently improve the functional occlusion and esthetic requirements of the patient.

Impact of two early treatment protocols for anterior dental crossbite on children's quality of life

ABSTRACT Objective: To assess the impact of two early treatment protocols for anterior dental crossbite on children's quality of life. Methods: Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children's quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Results: Children's mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. Conclusions: The difference regarding the impact on quality of life between groups is not related to the protocol used.

RESUMO Objetivo: avaliar o impacto de dois protocolos de tratamento precoce para a mordida cruzada anterior dentária na qualidade de vida de crianças. Métodos: trinta crianças de 8 a 10 anos de idade com mordida cruzada anterior dentária participaram desse estudo. Os indivíduos foram divididos em dois grupos: Grupo 1 - 15 crianças em tratamento com aparelho removível superior com molas digitais; Grupo 2 - 15 crianças em tratamento com batentes de cimento de ionômero de vidro resinoso nos primeiros molares permanentes inferiores. A qualidade de vida foi avaliada por meio da versão brasileira do Child Perceptions Questionnaire (CPQ8-10), o qual contém quatro subescalas: sintomas bucais (SB), limitações funcionais (LF), bem-estar emocional (BE) e bem-estar social (BS). Um escore mais alto indica um impacto mais negativo na qualidade de vida. As crianças responderam ao questionário antes do tratamento (T1) e 12 meses após o início do tratamento ortodôntico (T2). Estatística descritiva, o teste Wilcoxon e análise de covariância (ANCOVA) foram realizados. Resultados: a média de idade das crianças foi de 9,07 ± 0,79 anos no Grupo 1 e de 9,00 ± 0,84 no Grupo 2. Para o Grupo 1, os escores das subescalas LF e BE e o escore total do CPQ8-10 foram significativamente maiores em T1 do que em T2 (p= 0,004, p= 0,012 e p= 0,015, respectivamente). Para o Grupo 2, não houve diferença estatisticamente significativa. A ANCOVA não mostrou diferença significativa entre os grupos em relação à qualidade de vida em T2, após o controle para as medidas de qualidade de vida em T1. Conclusões: a diferença em relação ao impacto na qualidade de vida entre os grupos não foi relacionada ao protocolo de tratamento utilizado.

Tratamiento temprano de la mordida cruzada anterior: informe de un caso clínico / Early treatment of the anterior crossbite. a clinical case report

Objetivo: presentar un caso clínico de mordida cruzada anterior funcional tratado mediante la técnica de Pistas Directas Planas. Caso clínico: Niña de cuatro años de edad, con diagnósticode mordida cruzada anterior funcional en dentición decidua. Su tratamiento se realizó en el Servicio Integral I del Hospital de Odontología Infantil “Don Benito Quinquela Martín”. La corrección de la maloclusión se logró tras 2 meses de uso de las Pistas Directas Planas. Estas fueron removidas a los 6 meses, cuando se observó una correcta posiciónmandibular, intercuspidación posterior y una función oclusal estable, que devolvieron el equilibrio al sistema estomatognático. Conclusión: Las Pistas Directas Planas constituyen unaalternativa de tratamiento temprano para las maloclusiones. Su sencillez en la realización, su eficacia en los resultados y el bajo costo económico hace que sea un método de elección.

Aim: to illustrate a clinical case of functional anteriorcrossbite treated using Planas Direct Tracks.Case report: A four-year-old female patient withfunctional anterior crossbite in deciduous dentition wastreated at the “Don Benito Quinquela Martín” Children’sDental Hospital. The correction of the malocclusion wasachieved 2 months after using planas direct tracks. Thedevice was removed 6 months later getting a mandibularcorrect position and intercuspidation, returning the balanceto the stomatognathic system through a balancedocclusal function.Conclusion: The use of Planas Direct Tracks is an earlytreatment alternative for malocclusions. Its simplicity ofimplementation, efficiency in results and low cost makes it asuitable method.

Curative effect of TOMY self-ligation appliance technique in treatment of anterior crossbite and moderate crowding with non-extraction treatment:A case report and literature review / 吉林大学学报(医学版)

Objective:To observe the clinical effect of TOMY self-ligation appliance technique in the treatment of anterior crossbite and moderate crowding, and to explore its clinical application.Methods:A patient, manifested as anterior crossbite and moderate dentition crowing, diagnosed as Angle class Ⅲ subclass malocclusion, MaoⅡ1+Ⅰ1 malocclusion, high angle,and facial asymmetry, was selected.This patient was treated with TOMY self-ligation appliance technique without tooth extraction.The length and width of the dental arch, the width of the alveolar bone and the width of the basal arch were measured before and after treatment;the lateral radiographs of the patient were taken too.Results:After treatment,the upper and lower dentition arranged in neat rows, reached a neutral occlusal relationship;SNA, SNB and ANB had no obvious changes;the lip inclination of anterior teeth was increased by 10 degrees, and reached the normal value;the upper and lower dental arch width, alveolar bone width, basal bone arch width and dental arch length were lower than before treatment.Conclusion:For the patient with anterior crossbite and moderate dental crowding treated with non-extraction, the TOMY self-ligation technique can be considered to use, by increasing the arch width and length to improve the anterior crossbite and moderate crowding, in order to achieve the effective treatment.

Bite turbo inferior no tratamento da mordida cruzada anterior / Bite turbo lower in the treatment of anterior crossbite ­ a case report

Dentro os vários existentes para o tratamento da mordida cruzada anterior, foi escolhido um método simples, rápido e que dispensa a colaboração do paciente em um primeiro momento. Neste caso, foi utilizado planos individuais em resina fotopolimerizável nos incisivos inferiores, com inclinação suficiente para facilitar o descruzamento (aproximadamente 30°). No terceiro mês, foi obtido um resultado satisfatório no descruzamento da mordida.

Within the various methods available for the treatment of anterior crossbite, a simple, fast method was chosen, which does not require patient cooperation at first. In this case, individual planes made of light curing resin in the lower incisors, with sufficient 30-degree slope to correct the crossbite. In the third month satisfactory results were observed.

Cephalometric study on mandibular positions of functional anterior crossbite before and after treatment / 实用口腔医学杂志

Objective:To analysis the relationship of cephalometric measurements from intercuspal position(before and after treat-ment)and retruded contact position(before treatment).Methods:18 cases with Class III malocclusion were treated using MBT straight wire appliance technique,all the incisal relationships could be edge-to-edge when the mandible was retruded,X-ray films of intercus-pal position and retruded contact position before treatment and intercuspal position after treatment were taken.The cephalometric meas-urements were statistically analysed by ANOVA.Results:After 25 months treatment the anterior crossbite were corrected in all cases. The molar relationship were class Ⅰ.The measurements of SNB,ANB,MP-FH,MP-SN,U1-SN,L1-MP,Y-axis angle and ANS-Me were significantly changed.Conclusion:After the treatment of Class III malocclusion by MBT straight wire appliance,the sagittal and vertical mandibular location can be between intercuspal position and retruded contact position of pretreatment,and it is more close to the retruded contact position.

The Use of Catlan's Appliance For Repaid Correction of Pseudo Class III Malocclusion.

In this case report, the use of a cemented lower anterior inclined bite plane (Catlan’s appliance) for the correction of a pseudo Class III malocclusion is shown in a growing child. The differential diagnosis of pseudo malocclusion and the advantages and disadvantages of the use of Catlan’s appliance are discussed.

Treatment of a Class III growing patient with mandibular prognathism and severe anterior crossbite / Tratamento de paciente Classe III em crescimento com prognatismo mandibular e severa mordida cruzada anterior

The treatment of growing patients with Class III skeletal pattern represents one of the greatest clinical challenges for the orthodontist. Several treatment protocols have been proposed, almost all involving rapid maxillary expansion and maxillary protraction. However, there are cases where the maxilla is properly positioned in the anteroposterior direction and there is no transverse discrepancy, featuring only a mandibular prognathism. In such cases, when there is a set of favorable factors such as lack of laterognathism and lower mandibular plane angle, a viable option and which could prove quite interesting is the use of orthodontic chin cup during the night, aiming at trying to redirect the forward growth of the mandible. To have success, it is necessary that this procedure involves pubertal growth spurt and is extended to full skeletal maturation. This case was presented to the board of the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements to become a BBO Diplomate.

O tratamento de pacientes em crescimento com padrão esquelético de Classe III representa um dos maiores desafios clínicos para o ortodontista. Vários protocolos de tratamento têm sido propostos, quase todos envolvendo expansão rápida da maxila e protração maxilar. Porém, existem casos onde a maxila está corretamente posicionada no sentido anteroposterior e não há discrepância transversa, caracterizando apenas um prognatismo mandibular. Nesses casos, quando há um conjunto de fatores favoráveis, tais como ausência de laterognatismo e menor ângulo do plano mandibular, uma opção viável e que pode se mostrar bastante interessante é o uso noturno da mentoneira, com o objetivo de tentar redirecionar o crescimento anterior da mandíbula. Para que haja sucesso, é necessário que esse procedimento envolva o surto de crescimento da puberdade e seja estendido até a completa maturação esquelética. O presente caso clínico foi apresentado à diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), como parte dos requisitos para a obtenção do titulo de Diplomado pelo BBO.

The anterior dental cross-bite: the paradigm of interception in orthodontics / A mordida cruzada anterior: o paradigma da interceptação em ortodontia

OBJECTIVES: To present specific clinical interception procedures instituted to reduce malocclusionseverity on developmental stage. Anterior tooth cross-bite, involving one or two permanent teeth, is acommon form of malocclusion diagnosed in children about 6 years of age. RESULTS ANDDISCUSSION: Various devices can be suggested for single tooth cases, like removable cantilevereddouble-helix apparatus with digital springs, which is one of the most efficient to intercept malocclusion.In the other hand, fixed appliance does not depend on patient’s cooperation and have greater actionpower and liberates more continuous forces. CONCLUSION: Dental anterior cross-bite, involvingone tooth, can be corrected by means of the multi-loop arch wire with a double-helix, even in caseswhere adequate space for alignment is lacking.

OBJETIVOS: Apresentar procedimento de interceptação clínica específica para reduzir aseveridade da má oclusão no estágio de desenvolvimento. O cruzamento anterior, comprometendoum ou dois dentes permanentes, é forma comum de má-oclusão, diagnosticada em crianças emtorno de seis anos de idade. RESULTADOS E DISCUSSÃO: Vários dispositivos podem ser utilizados para casos de cruzamento de um dente apenas, como os aparelhos de duplo hélice emextremo livre, com molas digitais, um dos mais eficientes para interceptar más-oclusões. Poroutro lado, os aparelhos fixos não dependem da colaboração do paciente, tendo maior poder deação e de liberação de forças contínuas. CONCLUSÃO: Os cruzamentos anteriorescomprometendo um dente podem ser corrigidos por meio de arco com dobras múltiplas, comhélice dupla, mesmo em casos onde há deficiência de espaço para o alinhamento.

Morphological differences between functional and skeletal anterior cross-bite patients / 대한치과교정학회지

The purpose of this study was to compare the dento-skeletal characteristics between functional and skeletal anterior cross-bite patients. Twenty-eight functional anterior cross-bite patients and thirty-one skeletal anterior cross-bite patients were selected as a test and a control group. Mean ages of the test and the control group were 9.6+/-1.8 and 9.8+/-1.9, respectively. Lateral cephalograms were taken. Forty-nine cephalometric variables were measured and statistical analysis was performed to find the morphological differences between the groups. Statistically significant differences were found in the cephalometric variables of cranial deflection, maxillary depth, ANB, convexity, NPo-AB, APDI, Mx 1-SN, Mx 1-NA angle, Mx 1-NA, Md 1-NB angle and Md 1-NB. The test group showed more Class III growth potential, more protruded maxilla, lesser maxillo-mandibular difference, more uprighted and retruded maxillary central incisor, more labially tipped and protruded mandibular central incisor.

Modified fixed reverse Twin-block combined with maxillary protraction appliance in the treatment of AngleⅢ skeletal anterior crossbite / 实用口腔医学杂志

Objective: To evaluate the effects of the modified fixed r everse Twin-block appliance(TBA) combined with maxillary protraction appliance( MPA) in the treatment of early Angle Ⅲ skeletal anterior crossbite. Met hods:TBA combined with MPA was used in 15 growing subjects with early An gle Ⅲskeletal malocclusion (group TBA-MPA). Another 15 subjects with the same type of malocclusion were treated by MPA(group MPA). The effects of treatment we re studied by cephalometric measurments.Results:3-5 months afte r treatment SNB, B-Vert T, Po-Vert T,NPo-FH,Co-Po and 1-NB in group 1 were decreased more than those in group 2 (P0.05).Conclusion:Angle Ⅲ skeletal ante rior crossbite can be corrected successfully with reverse TBA combined with maxi llary protraction appliance by mandible retrusion and maxilla forward growth.

Dentofacial changes of anterior crossbite after modified maxillary protraction therapy / 中华医学美学美容杂志

Objective To introduce a modified intraoral fixed appliance for maxillary protraction and to investigate the dentofacial changes of anterior crossbite after the therapy. Methods Twelve patients with anterior crossbite were treated with modified protraction therapy. The cephalometric analysis was used to evaluate the changes. Results After active treatment, the overjet correction was 6.55 mm. A point moved forward 2.6 mm. Pg dislocated backward 5.65mm with MP-FH increased 1.7?. Esthetics was greatly enhanced. Conclusion The modified maxillary protraction is recommended for easy fabrication, good retention, wearing comfortably and cleaning easily. Esthetics is greatly enhanced.

A study on the effect of treatment in the skeletal Class III malocclusion patient with anterior crossbite / 대한치과교정학회지

The purpose of this study was to investigate the treatment effects on anterior crossbite patients using chin cap and labiolingual arch appliance. In the present study, I statistically evaluated measurement values on a cephalogram before and after treatment form twenty anterior crossbite cases. The results were as follows: 1. In the craniofacial patterns, cranial base increased after treatment. 2. In the maxillo-mandibular relationship, ANB and Facial convexity significantly increased. 3. In the denture patterns, occlusal plane, U1 to FH and Overjet significantly increased. On the contrary overbite decreased significantly. Lower incisors inclined lingually. 4. In the soft tissue profile changes, lower lip protrusion was significantly improved.

Anterior crossbite correction following craniofacial morphologic pattern in the early deciduous dentition / 대한치과교정학회지

Anterior crossbite is a common malocclusion in the early deciduous dentition. Even today, many these malocclusion patients are not treated until the mixed or permanent dentition. And the purpose here is to emphasize the need for early diagnosis and possible treatment for these anterior crossbite malocclusions and their associated facial patterns. Case histories of 4 patients selected from the author's practice are presented. Different methods of treatment are evaluated. Some improvement was achieved in all patients from an early interceptive regimen, although ultimately corrective orthodontic treatment may still be needed in some. It is concluded that early interception of deciduous anterior crossbite malocclusion should by attempted in patients; there should be no delemma in reaching such a decision. And it is essential for diagnosis and treatment to determine exact variations in growth when some appliance are used, it is recommended that growth-related records be made as early as possible.