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Posterior Maxillary Surgery: Its Place in the Treatment of Dentofacial Deformities
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Greg J Knepil, Graham R Oliver
Four indications for posterior maxillary surgery were described: Posterior maxillary hyperplasia with an open bite and satisfactory lip-to-tooth relationship and increase in lower anterior face height.Total maxillary alveolar hyperplasia, with an increase in vertical dimension and maxillary protrusion.Bilateral or unilateral maxillary crossbite, which may exist in isolation as the only dentofacial deformity or in combination with other deformities such as cleft.Distal repositioning of the posterior maxillary alveolus to create space for an unerupted maxillary canine or premolar.
Diseases of the Masticatory Complex
Published in Lars Granath, William D. McHugh, Systematized Prevention of Oral Disease: Theory and Practice, 2019
Gunnar E. Carlsson, Bengt Ingervall, George A. Zarb
In patients with a bilateral cross-bite the elimination of occlusal interference by tooth grinding may be difficult. In such patients correction of the cross-bite by forced expansion of the maxilla is possible only if undertaken prior to closure of the midpalatal suture which occurs some years after puberty. After that time occlusal therapy is possible only with elaborate surgical methods. Patients with lingual cross-bite (Figure 6) due to a discrepancy between the maxillary and mandibular apical bases are best treated during the growth period, where some of the discrepancy may be compensated for by remaining growth. In cases with lingual cross-bite, at least when several teeth are involved (Figure 6), orthodontic and surgical treatment are practically the only therapeutic possibilities. Even if no signs and symptoms of mandibular dysfunction are present in childhood, orthodontic treatment should be carried out when the potential for such treatment is optimal. The risk that at a later stage, such a lingual cross-bite would pose a therapeutic risk should not be undertaken (Figure 7).
Dental Anatomy and Occlusion
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Pedro E. Santiago, Lindsay A. Schuster
In normal occlusion, all maxillary teeth overlap the mandibular teeth. When one or more teeth of one arch has an abnormal transverse or anteroposterior relationship with the opposing arch, it is described as a crossbite. Crossbites may have dental or skeletal origins. A dental crossbite is caused by improperly inclined and/or malpositioned teeth, and is usually resolved through orthodontic dental movement. Skeletal crossbites are caused by a difference in size between the maxilla and the mandible. The discrepancy could be sagittal or transverse, creating an anterior or posterior crossbite that may be unilateral or bilateral. An anterior crossbite is when the labial surface of a maxillary anterior tooth occludes posterior to the lingual surface of a mandibular anterior tooth (see Fig. 4-16). A posterior crossbite is when the buccal surface of a maxillary tooth occludes with the lingual surface of a mandibular tooth. Correcting these crossbites usually requires a palatal expander or orthognathic surgery (Fig. 4-17).
Early orthodontic treatment in a Finnish public health centre: a retrospective cross-sectional study
Published in Acta Odontologica Scandinavica, 2023
Annika Arpalahti, Anni Saarnio-Syrjäläinen, Sirkku Laaksonen, Heidi Arponen
Treatment of skeletal class III malocclusion and anterior crossbite with protraction facemask before the age of 10 years is effective [43,44]. The prevalence of class III malocclusion in individuals of European descent aged over 11 years is 4.9% (range 1.0–9.7%) [45]. In a Finnish study analysing children at onset of mixed dentition phase, the prevalence of anterior crossbite was 2.2% [2]. In our sample, 10% of patients in treatment (2.7% of the whole sample) had protraction facemask therapy, implying that class III malocclusion and/or anterior crossbite is treated early in this healthcare centre. Thus, the orthodontic treatment practice is in line with the recommendations in the literature.
Molar protraction on an adult with severe high-angle Class III malocclusion and knife-edge residual ridges
Published in Orthodontic Waves, 2021
Adith Venugopal, Mona Sayegh Ghoussoub, Paolo Manzano, Prateek Mehta, Anand Marya, Nikhilesh R Vaid, Björn Ludwig, S. Jay Bowman
Post-treatment results showed an improved profile and Class I canine and molar relationships, with optimal overjet and overbite. The anterior and posterior crossbite was corrected. The knife-edge residual ridges at the lower posterior region were closed successfully by protraction of the lower second molars (Figure 5). The gingiva surrounding the lower molars looked healthy demonstrating optimum periodontal health. Extraoral photographs displayed a relaxed lip closure and an aesthetic smile meeting the patient’s expectations. The post-treatment panoramic radiograph demonstrated proper root parallelism (Figure 6).
Removable appliances to correct anterior crossbites in the mixed dentition: a systematic review
Published in Acta Odontologica Scandinavica, 2020
An anterior crossbite is defined as an abnormal reversed labiolingual relationship of the incisors, where one or more primary or permanent maxillary incisors are located palatally to the mandibular incisors [1]. The prevalence of the anterior crossbite in the literature varies between 2.2% and 12% depending on the age of participants, ethnicity of the included subjects and the type of the anterior crossbite included in the data [2]. The anterior crossbite can be classified into: (1) An anterior dental crossbite caused by abnormal axial inclinations of the maxillary incisors resulting from trauma to a primary or permanent tooth bud, retained primary teeth, supernumerary teeth, an arch deficiency or an upper lip biting habit [3–5]. (2) A functional anterior crossbite due to the presence of premature occlusal contacts which in turn cause the mandible to shift anteriorly away from the normal path of closure and lead to what is called a pseudo-class III malocclusion [6]. (3) Skeletal anterior crossbite which is caused by a retrognathic maxilla, prognathic mandible or a combination of both due to genetic factors [7]. Furthermore, an anterior crossbite can lead to an adverse complication including gingival recession and mobility [8–10], TMJ disorders [11,12], as well as dental and facial disharmony [13–15]. Therefore, it’s highly recommended to correct an anterior crossbite in the deciduous or early mixed dentition to allow a normal development of the occlusion and jaws. To date, several treatment modalities have been proposed to correct the anterior crossbite [16], but none was based on high-quality evidence. Therefore, the aim of this systematic review was to investigate the effectiveness of an upper removable appliance in the treatment of an anterior crossbite in term of quality of life, effectiveness, treatment time, long term stability and cost minimization.