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TREATMENT OF
CROSSBITE

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.india...
DEFINITION


Cross bite is a deviation of the normal bucco-lingual
relationship of the teeth of one arch with those of th...
CLASSIFICATION
According to their location in the arch
• Anterior Crossbite

• Posterior Crossbite
Unilateral Crossbite
Bi...
CLASSIFICATION
According to the number of teeth
involved
•Single tooth Crossbite

•Segmental Crossbite
www.indiandentalaca...
CLASSIFICATION
Based On Etiological Factors Responsible For
The Crossbite
•Dental Crossbite
•Skeletal Crossbite
•Functiona...
Dental Crossbite
•These are usually caused due to arch length discrepancy or
an abnormal path of eruption

Skeletal Crossb...
Functional Crossbite
These cross bites are usually caused due to presence

of occlusal interferences during the act of br...
Buccal non occlusion:( scissors bite )
 This is a condition where the maxillary posterior teeth palatal

cusp are placed ...
Etiology of Crossbite
Anomalies of number
supernumerary teeth
missing teeth
Anomalies of tooth size

Anomalies of tooth...
Delayed eruption of permanent teeth
Abnormal eruptive path
 Ankylosis
 Presence of habits such as thumb sucking and mo...
CORRECTION OF ANTERIOR
CROSSBITE
In preadolescent age group
1. Use of tongue blade


Tongue blade can correct developing ...
Opposing mandibular tooth acts as fulcrum and the patient

is asked to rotate the oral part of the blade upward and
forwa...
2.Catlan’s appliance
 It is lower anterior inclined plane used to treat maxillary
teeth in Crossbite
 It has a 450 angul...
Advantages of Catlan's appliance
Ease of fabrication
Rapidity of correction using functional and muscle forces
Lack of ...
Disadvantages of Catlan's appliance
 The patient has difficulty in speech and chewing
 Appliance acts as anterior bite p...
3.Face mask
 In cases of anterior crossbite due to an actual skeletal
deficiency of maxilla it is possible to mesialize t...
4.Functional regulator III
A FR III appliance can be used to correct developing class
III skeletal jaw structure
The appli...
5.Chin cup
 A chin cup can be used to redirect the growth of mandible
to prevent or correct the anterior crossbite due to...
CORRECTION OF ANTERIOR
CROSSBITE
In adolescent and adults
1.Jack screw


Mini or medium size screws can be used to correc...
2.Double cantilever spring:( Z spring )
• Anterior Crossbite involving one or two teeth can be
treated using a double cant...
•The parallel arms ca be activated as per the requirement to
either push the entire tooth labially or just the mesial or
d...
3. Fixed appliances
Labial arch wire with vertical spring loop
 Used to correct incisor lingual cross bite in case where
...
The vertical spring loops at the molar tubes are

opened to advance the arch wire
This exerts a labial vector of force o...
CORRECTION OF POSTERIOR
CROSSBITE
1.Coffin Spring
 This is an omega shaped wire (0.9 mm ) in a removable

appliance used ...
2.T Spring
T spring can be used for buccal movement of
premolars
It is made of 0.5 mm hard round stainless steel wire
Spri...
3.Jack screw
A jack screw can used in the removable plate to carry out

expansion to correct the posterior cross bite
Th...
4.Quad helix
It

is a fixed appliance soldered to the molar bands
cemented generally on the first permanent maxillary mol...
5.Rapid maxillary expansion
Bilateral skeletal cross bite with a deep palate and narrow
maxilla can be treated by RME wher...
The

RME screw can be incorporated in two type of
appliances: Banded RME and cemented RME
The

appliance produces rapid ...
6.Fixed appliances
The arch wires can be kept expanded or
constricted depending upon the movement required
Cross elastic...
They require lingual attachments (spur, button )along with
the usual Buccal attachments


Bolstering

anchorage can be u...
NITI Expanders
These are nickel titanium wires which can be attached to
the lingual sheath that are welded to the molar b...
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Treatment of crossbite /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in

continuing dental education , training dentists

in all aspects of dentistry and offering a wide

range of dental certified courses in different

formats.

Indian dental academy provides dental crown &

Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit

www.indiandentalacademy.com ,or call
0091-9248678078

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Treatment of crossbite /certified fixed orthodontic courses by Indian dental academy

  1. 1. TREATMENT OF CROSSBITE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. DEFINITION  Cross bite is a deviation of the normal bucco-lingual relationship of the teeth of one arch with those of the apposing arch  T.M GRABER Cross bite is a condition where one or more teeth may be malposed abnormally,bucally lingually or labially with reference to the opposing tooth or teeth www.indiandentalacademy.com
  3. 3. CLASSIFICATION According to their location in the arch • Anterior Crossbite • Posterior Crossbite Unilateral Crossbite BilaterialCrossbite www.indiandentalacademy.com
  4. 4. CLASSIFICATION According to the number of teeth involved •Single tooth Crossbite •Segmental Crossbite www.indiandentalacademy.com
  5. 5. CLASSIFICATION Based On Etiological Factors Responsible For The Crossbite •Dental Crossbite •Skeletal Crossbite •Functional Crossbite www.indiandentalacademy.com
  6. 6. Dental Crossbite •These are usually caused due to arch length discrepancy or an abnormal path of eruption Skeletal Crossbite •These are primarily due to mal positioning or malformation of the jaws •These can be  Inherited –Class III skeletal pattern  Congenital –Cleft lip and palate cases  Due to trauma at the time of birth www.indiandentalacademy.com
  7. 7. Functional Crossbite These cross bites are usually caused due to presence of occlusal interferences during the act of bringing the jaws into occlusion These can be caused by the early loss of deciduous teeth, decayed teeth or ectopically erupted teeth www.indiandentalacademy.com
  8. 8. Buccal non occlusion:( scissors bite )  This is a condition where the maxillary posterior teeth palatal cusp are placed completely buccal to the mandibular posterior teeth Lingual non occlusion  Here the maxillary posterior teeth are placed completely palatal to the lingual aspect of the mandibular posterior teeth www.indiandentalacademy.com
  9. 9. Etiology of Crossbite Anomalies of number supernumerary teeth missing teeth Anomalies of tooth size Anomalies of tooth shape Premature loss of deciduous and/or permanent teeth www.indiandentalacademy.com Prolonged retention of deciduous teeth
  10. 10. Delayed eruption of permanent teeth Abnormal eruptive path  Ankylosis  Presence of habits such as thumb sucking and mouth breathing can result in narrowing of the dental arch leading to posterior Crossbite www.indiandentalacademy.com
  11. 11. CORRECTION OF ANTERIOR CROSSBITE In preadolescent age group 1. Use of tongue blade  Tongue blade can correct developing crossbite  It resembles a flat ice cream stick  It is placed inside the mouth contacting the erupting tooth in Crossbite on its palatal aspect www.indiandentalacademy.com
  12. 12. Opposing mandibular tooth acts as fulcrum and the patient is asked to rotate the oral part of the blade upward and forward The proper use of tongue blade for an hour or two for 10 to 15 days is usually sufficient www.indiandentalacademy.com
  13. 13. 2.Catlan’s appliance  It is lower anterior inclined plane used to treat maxillary teeth in Crossbite  It has a 450 angulation which forces the maxillary teeth in Crossbite to a more labial position Prerequisites for use of inclined plane  Enough space in maxillary arch to align the teeth/tooth  Mandibular incisors should be well aligned to allow appliance fabrication  Developmental status of mandibular incisors should be such that they can tolerate the forces generated www.indiandentalacademy.com
  14. 14. Advantages of Catlan's appliance Ease of fabrication Rapidity of correction using functional and muscle forces Lack of soreness or looseness of teeth during treatment Rarity of relapse www.indiandentalacademy.com
  15. 15. Disadvantages of Catlan's appliance  The patient has difficulty in speech and chewing  Appliance acts as anterior bite plane and prevents posterior teeth from coming in contact  Appliance cannot be given if mandibular incisors are periodontically compromised  Prolonged use of appliance can lead to anterior open bite Possibility of appliance becoming loose and requiring recementation because of strong occlusal stresses upon it www.indiandentalacademy.com
  16. 16. 3.Face mask  In cases of anterior crossbite due to an actual skeletal deficiency of maxilla it is possible to mesialize the maxilla using a protraction face mask  If the maxilla is narrow a rapid maxillary expansion screw can be employed simultaneously Petit Face Mask www.indiandentalacademy.com
  17. 17. 4.Functional regulator III A FR III appliance can be used to correct developing class III skeletal jaw structure The appliance stretches the soft tissue envelop around the maxilla stimulating its anterior growth as well as preventing the mandible from growing any further anteriorly www.indiandentalacademy.com
  18. 18. 5.Chin cup  A chin cup can be used to redirect the growth of mandible to prevent or correct the anterior crossbite due to a prominent mandible  Chin cup tends to rotate the mandible downward and backward www.indiandentalacademy.com
  19. 19. CORRECTION OF ANTERIOR CROSSBITE In adolescent and adults 1.Jack screw  Mini or medium size screws can be used to correct single tooth or segmental anterior Crossbite in adults  The patient should be cooperative enough to maintain and activate the screw or at least get it activated at regular intervals www.indiandentalacademy.com
  20. 20. 2.Double cantilever spring:( Z spring ) • Anterior Crossbite involving one or two teeth can be treated using a double cantilever spring provided there is adequate space • It consist double helix between two parallel arms and the inferior arm extends as retentive component www.indiandentalacademy.com
  21. 21. •The parallel arms ca be activated as per the requirement to either push the entire tooth labially or just the mesial or distal aspect to correct a mesio-palatal/lingual or distopalatal/lingual rotation of the tooth respectively •The spring should be used along with posterior bite plane www.indiandentalacademy.com
  22. 22. 3. Fixed appliances Labial arch wire with vertical spring loop  Used to correct incisor lingual cross bite in case where guide plane is contraindicated  The lingually malposed incisor is ligated to the arch wire www.indiandentalacademy.com
  23. 23. The vertical spring loops at the molar tubes are opened to advance the arch wire This exerts a labial vector of force o the ligated tooth with the reciprocal force being directed against the molars www.indiandentalacademy.com
  24. 24. CORRECTION OF POSTERIOR CROSSBITE 1.Coffin Spring  This is an omega shaped wire (0.9 mm ) in a removable appliance used for expansion to correct the posterior cross bite  The expansion produced is slow and bilaterally symmetrical  If used in mixed dentition stage the appliance is capable of producing skeletal changes www.indiandentalacademy.com
  25. 25. 2.T Spring T spring can be used for buccal movement of premolars It is made of 0.5 mm hard round stainless steel wire Spring consist of t shaped arm whose ends are embedded in acrylic Spring is activated by pulling the free end of T towards the intended direction of tooth movement www.indiandentalacademy.com
  26. 26. 3.Jack screw A jack screw can used in the removable plate to carry out expansion to correct the posterior cross bite The patient should cooperative to maintain the appliance and activate the screw or atleast get it activated at regular intervals www.indiandentalacademy.com
  27. 27. 4.Quad helix It is a fixed appliance soldered to the molar bands cemented generally on the first permanent maxillary molars It can be reactivated using the three pong plier without having to be removed from the oral cavity It is a versatile appliance and can be used with usual fixed appliance therapy It can produce skeletal effects if given in preadolescent www.indiandentalacademy.com
  28. 28. 5.Rapid maxillary expansion Bilateral skeletal cross bite with a deep palate and narrow maxilla can be treated by RME where the mid palatal suture is split  It incorporates a screw which is activated 0.5 – 1 mm/day The force level can build upto 10 to 20 pounds as the screw is turned at this rate www.indiandentalacademy.com
  29. 29. The RME screw can be incorporated in two type of appliances: Banded RME and cemented RME The appliance produces rapid expansion in 3-4 weeks After expansion the appliance itself acts as retainer www.indiandentalacademy.com
  30. 30. 6.Fixed appliances The arch wires can be kept expanded or constricted depending upon the movement required Cross elastics  Cross elastics can be used to bring about correction of individual tooth cross bites in posterior segment www.indiandentalacademy.com
  31. 31. They require lingual attachments (spur, button )along with the usual Buccal attachments  Bolstering anchorage can be used to prevent to far buccal or lingual movement of the teeth under the influence of cross elastics www.indiandentalacademy.com Bolstering anchorage
  32. 32. NITI Expanders These are nickel titanium wires which can be attached to the lingual sheath that are welded to the molar bands cemented on the maxillary permanent first molars  Various sizes are available and need to be selected depending upon the expansion desired and the pretreatment width of the palate   It brings about slow expansion www.indiandentalacademy.com
  33. 33. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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