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Dr. JUNAID DAYAR
A discrepancy in the buccolingual relationship of the  upper and lower teeth.By convention the transverse relationship of ...
The buccal cusps of the lower teeth occludebuccal to the buccal cusps of the upper teeth
the buccal cusps of the lower teeth occludelingual to the lingual cusps of the upper teeth
   Local causes   Skeletal causes
   The most common local cause is crowding    where one or two teeth are displaced from the    arch   early loss of a se...
   mismatch in the relative width of the arches e.g    in thumb sucking, CLAP
   an anteroposterior discrepancy, which results    in a wider part of one arch occluding with a    narrower part of the ...
   Cross bites can also be associated with true    skeletal asymmetry e.g trauma to TMJ,    Hemifacial microsomia, Hemima...
   Anterior cross bite   Posterior cross bite
   An anterior crossbite is present when one or    more of the upper incisors is in linguo-    occlusion (i .e. in revers...
  Cross bites of the premolar and molar region   involving one or two teeth or an entire buccal   segment. can be subdiv...
  deflecting contact on closure into the cross  bite. can affect only one or two teeth (dental) maxillary arch is of ”s...
   less common   Can be dental/ skeletal
   more likely to be associated with a    skeletal discrepancy, either in the    anteroposterior or transverse dimension,...
   This type of crossbite is most commonly due to    displacement of an individual tooth as a result    of crowding or re...
This crossbite is typically associated with an underlying skeletal discrepancy. often a Class II malocclusion with the upp...
   A developing cross bite can be managed by:1) Tongue blade therapy2) Lower Inclined plane therapy3) Posterior bite block
  A.C.B which ha s already developed can be   treated by:1)Double cantilever spring with posterior bite   plane2)Fixed ap...
   Maxillary expansion   Proclination of upper and retoclination of    lower anterior teeth by fixed appliance (class II...
   Cross elastics   fixed appliance
   Eliminate sucking habits   Remove any tooth interferences   Maxillary expansion (rapid/slow)   Orthognathic surgery
   Done in adolescents and adults where strong    interdigitation of suture is present   This creates 10 to 20 pounds of...
   Done in preadolescent children esp with cleft   2 pounds of pressure   0.5 mm-1mm per week   damage and hemorrhage ...
Cross bite
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Cross bite

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Cross bite

  1. 1. Dr. JUNAID DAYAR
  2. 2. A discrepancy in the buccolingual relationship of the upper and lower teeth.By convention the transverse relationship of the arches is described in terms of the position of the lower teeth relative to the upper teeth.
  3. 3. The buccal cusps of the lower teeth occludebuccal to the buccal cusps of the upper teeth
  4. 4. the buccal cusps of the lower teeth occludelingual to the lingual cusps of the upper teeth
  5. 5.  Local causes Skeletal causes
  6. 6.  The most common local cause is crowding where one or two teeth are displaced from the arch early loss of a second deciduous molar causing a second premolar to erupt palatally/lingually retention of a primary tooth can deflect the eruption of the permanent successor leading to a cross bite.
  7. 7.  mismatch in the relative width of the arches e.g in thumb sucking, CLAP
  8. 8.  an anteroposterior discrepancy, which results in a wider part of one arch occluding with a narrower part of the opposing jaw e.g sk.cl II, sk cl III
  9. 9.  Cross bites can also be associated with true skeletal asymmetry e.g trauma to TMJ, Hemifacial microsomia, Hemimandibular hypertrophy
  10. 10.  Anterior cross bite Posterior cross bite
  11. 11.  An anterior crossbite is present when one or more of the upper incisors is in linguo- occlusion (i .e. in reverse overjet) relative to the lower arch Anterior crossbites are frequently associated with displacement on closure
  12. 12.  Cross bites of the premolar and molar region involving one or two teeth or an entire buccal segment. can be subdivided as follows.1) Unilateral buccal crossbite with displacement2) Unilateral buccal crossbite with no displacement3) Bilateral buccal crossbite4) Unilateral lingual crossbite5) Bilateral lingual crossbite (scissors bite)
  13. 13.  deflecting contact on closure into the cross bite. can affect only one or two teeth (dental) maxillary arch is of ”similar width” to the mandibular arch (i.e. it is too narrow) with the result that on closure the buccal segment teeth meet cusp to cusp. In order to achieve a more comfortable and efficient intercuspation, the patient displaces their mandible to the left or right
  14. 14.  less common Can be dental/ skeletal
  15. 15.  more likely to be associated with a skeletal discrepancy, either in the anteroposterior or transverse dimension, or in both.
  16. 16.  This type of crossbite is most commonly due to displacement of an individual tooth as a result of crowding or retention of the deciduous predecessor
  17. 17. This crossbite is typically associated with an underlying skeletal discrepancy. often a Class II malocclusion with the upper arch furtherforward relative to the lower so that the lower buccal teeth occlude with a wider segment of the upper arch
  18. 18.  A developing cross bite can be managed by:1) Tongue blade therapy2) Lower Inclined plane therapy3) Posterior bite block
  19. 19.  A.C.B which ha s already developed can be treated by:1)Double cantilever spring with posterior bite plane2)Fixed appliance(2 x4)
  20. 20.  Maxillary expansion Proclination of upper and retoclination of lower anterior teeth by fixed appliance (class III camouflage) Facemask therapy Orthognathic suregry to correct the jaw at fault
  21. 21.  Cross elastics fixed appliance
  22. 22.  Eliminate sucking habits Remove any tooth interferences Maxillary expansion (rapid/slow) Orthognathic surgery
  23. 23.  Done in adolescents and adults where strong interdigitation of suture is present This creates 10 to 20 pounds of pressure across the suture-enough to create microfractures of interdigitating bone spicules rate of 0.5 to I mm/day 2 to 3 week The expansion device is left in place for 3 to 4 months new bone forms in the space at the suture, and the skeletal expansion is stable
  24. 24.  Done in preadolescent children esp with cleft 2 pounds of pressure 0.5 mm-1mm per week damage and hemorrhage at the suture are minimized expansion is completed in 2 to 3 months

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