Transcript crossbite

Anterior Crossbite
（A）the etiology of Anterior Crossbite
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Genetic and congenital factors：
mandibular prognathism
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Acquired factors：
bad feeding posture
the primary canines interference
mouth breathing
bad habits
cleft palate
（B）The performance of anterior
crossbite
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Malocclusion
Jaw dysplasia and Craniofacial anomalies
（C）Class III presentations
In accordance with Pathogenic mechanism
 dental
 skeletal (Three) ：
1 Maxillary involvement : Maxillary
Deficiency
2 Mandibular involvement: Mandibular
Excess
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3 Maxillary and mandibular involvement
Functional
（C）The categories of anterior
crossbite
crossbite of dental origin：
1. Anterior crossbite
2. Usually class I skeletal pattern
Neutrocclusion of molars
3. Normal soft tissue profile
4. Anterior teeth can retrude edge to
edge
(Convenience shift of mandible)
（C）Categories
crossbite of skeletal origin：
It is due to excessive mandibular growth，in
addition to anterior crossbite ，there are
obvious mandibular deformity、protrusive、
obtuse mandibular angle，class Ⅲ
malocclusion；Soft tissue profile is concavetype.A skeletal problem, without the ability to
bring the incisors to edge-to-edge.
（C）Categories
crossbites of skeletal origin：
The skeletal class Ⅲ malocclusion is
characterized by mandibular prognathism ,
maxillary deficiency , or a combination of
both. The patients may have a retrusive
nasomaxillary area and a prominent lower
third of the face , with a reverse overjet.
Peking University, sagittal bonederived typing
（C）categories
crossbite of functional origin ：
By factors such as primary canine lack of
occlusion wear, or habitual mandibular
protrusion caused pseudo-mandibular
protrusion. Such patients also have a normal
skeletal mandibular pattern，the incisors show
negative overjet in CO but touch edge-to-edge
in CR. Anterior teeth can retrude edge-to-edge
（C）Categories
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According to the relationship between
vertical facial points
hyperdivergent , high-angle
hypodivergent , low-angle
average-angle
（D） The differential diagnosis
Dental
Functional Skeletal
Profile type normal
Staight
Concave
ANB angle normal
00 ～10
<-40
Mandible
CO\CR
Can
Can not
Can
（E）Treatment planning
characteristic
 1.complexity
 2.timeliness
 3.recrudescence
 Crossbite should be treated as soon as
it’s discovered，it can be treated
successfully through early orthodontic
and orthopedic intervention.

（E）Treatment planning
Crossbite occlusion: be dental or
functional.No matter what reason, early
treatment is very important.
a、primary crossbite
Treatment ：
1 . Occlusal adjustment：
occlusal
interference leading to a mandibular
shift.Early occlusal adjustment contribute to
normal growth and development of the
mandible.
a、 crossbite of primary dentition
Treatment ：
2. plate appliance：Can be applicable
to primary tooth roots which are still not
resorbed entirely ，Since the anterior
crossbite are caused by the lingual incisors .
The plate appliance need enough anchorage,
take the advantage of lingual spring push the
incisors out in order to correct the crossbite
relationship.
a、crossbite of primary dentition
Treatment ：
2. plate appliance ： As the primary
teeth root labial movement, permanent teeth
root will also be with the side to the same
direction, guiding the permanent anterior
teeth erupt normally .But the correct of the
primary dentition crossbite doesn’t mean the
treatment of the permanent dentition
crossbite.
a、 crossbite of primary dentition
3. FR-3 appliance：
b、Mixed-dentition crossbite
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dental
skeletal
A hand-wrist x-ray can be helpful in
assissing whether the patient has
substantial growth remaining
Functional
b、 crossbite of Mixed-dentition
Treatment ：
a. Bite appliance
b plate appliance
b、 mixed-dentition
Treatment ：
3 protraction appliance：Applicable to
patients with maxillary deficiency.The
orthopedic facial mask is attached to hooks on
a bonded expander by way of strong elastics
that produce up to 450 g of force per side.
Producing a forward movement of the maxilla.
b、 mixed-dentition
Method ：
c protraction appliance ：
Mouth parts
Clasp retention
Archwire
plate
hook
b、Mixed dentition crossbite
Treatment ：
3 reverse headgear：
Facemask
Forehead anchorage
chin anchorage
hook
b、 Mixed dentition crossbite
Therapy ：
4. chin cup: anterior crossbite with
a relatively normal maxilla and a
moderately protrusive mandible
can be treated with a chin cup. The
force line is directed through the
head of condyle，About 400g on
each side.
c、 crossbite of Permanent
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Dental
mild skeletal
camouflaged orthodontic technique
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serious skeletal : orthognathic surgery
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c、 Permanent crossbite
Treatment method ：
1. fixed appliance：
Applicable to dental crossbite and straight
profile type，fixed appliance can be used to
move the upper incicors out of crossbite ，
combination of class III elastics to adjust the
arch relationship.
c、 Permanent crossbite
Treatment method ：
2. orthodontic – orthognathic surgery ：
class III patients with significant
anteroposterior jaw discrepancies that cannot
be camouflaged with orthodontic tooth
movement will have to be treated surgically.
c、 Permanent crossbite
Treatment ：
2. orthodontic – orthognathic surgery ：
procedure ：Mainly due to bone
malformations and remove the existence of
compensatory tooth in order to correct the
angle the teeth of the jaw . So that the
maxillary teeth to the lingual position,
mandible teeth to labile potion .
c、 Permanent crossbite
therapy：
2.orthodontic – orthognathic surgery：
surgery progress ：the maxilla may be
brought forward with a lefort Ⅰsurgical
osteotomy procedure or the mandible may be
set back with a bilateral sagittal split osteotomy
, also can be at the same time do either
maxillary and mandible surgery .
Summary
Anterior crossbite
Dental
skeletal
functional
Primary dentition
Mixed-dentition
Permanent dentition