Anterior and posterior crossbite. Flashcards
(75 cards)
1
Q
Anterior and posterior crossbite
Jaw relationship discrepancies that can lead to malocclusions
A
- Disturbances in tooth number: hypodontia or hyperodontia
- Tooth malpositions
- Dysfunctions affecting jaw growth: influence overall development of jaw
- Genetic factors: Size of jaws and certain malocclusions determined by genetic inheritance
2
Q
Anterior and posterior crossbite
How malocclusions determined in the three planes of space
A
- Sagittal plane: antero-posterior relationship of dental arches, w/ classifications such as:
- Class I (neutroocclusion): Normal occlusion.
- Class II (distocclusion): Lower jaw positioned behind upper jaw.
- Class III (mesiocclusion): Lower jaw positioned ahead of upper jaw
-
Transverse plane:evaluates crossbites in posterior region, which can involve single or group of teeth, resulting in:
Crossbite of single tooth
Crossbite of a group of teeth in posterior segment -
Vertical plane: assesses issues such as:
Deep bite: Excessive vertical overlap of front teeth.
Open bite: Lack of vertical overlap between upper and lower teeth
3
Q
Anterior and posterior crossbite
Class I malocclusion with crossbite
A
- When discrepancy in buccolingual relationship between upper and lower teeth, despite normal antero-posterior occlusion
- It is categorized into:
- Anterior crossbite: Involves one or two incisors.
- Posterior crossbite: Involves either single teeth or entire buccal segment
4
Q
Anterior and posterior crossbite
Common causes (etiology) of anterior crossbite
A
- Premature extraction of primary teeth
- Trauma to primary dentition=>
- Intrusion, luxation, or expulsion
- Overretained primary teeth=>
- Block eruption of permanent successors
- Heredity
- Crowding
- Oral habits=>
- Thumb-sucking or tongue thrusting
- Rare causes=>scar tissue from cleft repair surgeries
5
Q
Anterior and posterior crossbite
How anterior crossbite clinically evaluated and diagnosed
A
- Extraoral examination: assess facial aesthetics and any obvious jaw discrepancies
- Intraoral examination: check for crossbite in anterior segment
- Diagnosis=>
- Clinical evaluation, study casts, and radiographic exams like orthopantomogram (OPG) and cephalometry
6
Q
Anterior and posterior crossbite
Treatment approaches for anterior crossbite
A
- Space gaining in arch: Allow proper alignment of teeth
- Bite opening: To reposition teeth into correct alignment
- Repositioning teeth: appliances to achieve correct tooth positioning
7
Q
Anterior and posterior crossbite
Appliances used in the treatment of anterior crossbite
A
- Schwarz appliance, which helps guide jaw growth and reposition teeth
- Lingual plate w/ occlusal coverage of posterior teeth and screws=>
- Mechanical force to correct tooth positioning
- Fixed appliances: w/ severe dental discrepancies to guide teeth into proper alignment
8
Q
Anterior and posterior crossbite
Clinical manifestations of anterior crossbite
A
- Extraoral signs: concave facial profile and a prominent chin
- Intraoral signs: anterior crossbite, gingivitis, and recessions
- Functional issues: Difficulty w/ normal mastication, extra effort required for biting and chewing
- Issues w/ lateral mandibular movements
9
Q
Anterior and posterior crossbite
Treatment plan for correcting anterior crossbite
A
- Targeting maxilla, mandible, or both jaws
- Increasing upper arch length: Through bite opening and proclination of upper incisors
- Decreasing lower arch length: Through retroclination of lower incisors
- Stimulating development of apical base: Particularly in frontal segments to support proper alignment of teeth
10
Q
Anterior and posterior crossbite
Why regular check-ups important during mixed dentition for crossbite treatment
A
- Monitor development of dentition, especially:
- Controlling eruption of incisors: Ensuring no edge-to-edge tendencies or improper inclinations
- Assessing crowding: Identifying space available for teeth and addressing crowding early to prevent crossbite from worsening
11
Q
Anterior and posterior crossbite
Appliances used to treat crossbite in primary dentition
A
- Prophylactic appliances: correct oral habits, such as thumb sucking or tongue thrusting
- Lingual plate w/ occlusal coverage and screw: procline upper segment of teeth
- Chin cup: functional appliance addressing jaw growth discrepancies
- Functional appliances: guide jaw and tooth development
- i-3 trainer: addresses crossbite issues by aligning bite and addressing habits
12
Q
Anterior and posterior crossbite
Factors determining treatment plan for crossbite in mixed dentition
A
- Number of teeth involved in crossbite
- Overlap of incisors
- Amount of crowding present
- Determining which jaw affected by malocclusion
13
Q
Anterior and posterior crossbite
Recommended age for treating crossbite in mixed dentition
A
- 8–9 years
- After eruption of permanent incisors
- Jaws still growing, making correction easier and more effective
14
Q
Anterior and posterior crossbite
Specific Appliances used to treat crossbite in mixed dentition
A
- Lingual plate in upper jaw
- Lingual plate in lower jaw
- Functional appliances: Such as the Klammt and Frankel II=>
- Guide growth and movement of jaw and teeth
- Schwarz appliance: crossbite involving 1–2 teeth if enough space present in upper arch and incisors properly erupted and aligned
15
Q
Anterior and posterior crossbite
Exercises for crossbite treatment
A
- Wooden stick or spatula=>
- Correct crossbite, particularly when only one or two teeth involved
- Guide teeth into proper position by encouraging muscle function and tooth movement
16
Q
Anterior and posterior crossbite
Treatment approaches for crossbite in permanent dentition
A
- Similar to that in mixed dentition, but w/ greater emphasis on maintaining correction long-term
- Removable appliances: minor corrections or in cases where growth guidance still necessary
- Fixed appliances: Crossbite correction part of first treatment stage, focussing on leveling and aligning teeth
17
Q
Anterior and posterior crossbite
Retention protocol after treating crossbite in permanent dentition
A
- Aims to maintain proper occlusal relationship achieved during treatment
- The goals include:
- Establishing normal occlusal relationship in anterior segment
- Ensuring overlap of incisors 1/3 to 1/2
- Achieving optimal axial inclination of incisors for proper function and aesthetics
18
Q
Anterior and posterior crossbite
Posterior crossbite definition
A
- Abnormal labio-lingual relationship of teeth in posterior segment of mouth
- Transversal deviation in occlusion
- Unilateral or bilateral misalignment
- Single or group of teeth affected
19
Q
Anterior and posterior crossbite
Different types of posterior crossbite
A
- Cusp-to-cusp crossbite: Cusps of opposing teeth in direct contact with each other
- Lingual occlusion: upper teeth lingual to lower teeth
- Buccal occlusion: upper teeth buccal to lower teeth
20
Q
Anterior and posterior crossbite
Main causes of posterior crossbite
A
- Underdevelopment of Jaw:
- Upper Jaw: Associated w/ cleft lip and palate, mouth breathing (causing compression), and genetic or congenital factors
- Lower Jaw: hypodontia or inherited traits.
- Overdevelopment of Jaw:
- Upper Jaw: overretained primary teeth, supernumerary teeth, and hereditary traits
- Lower Jaw: macroglossia, hereditary traits, and overretained primary teeth
21
Q
Anterior and posterior crossbite
Clinical manifestations of posterior crossbite
A
- Extraoral: no visible extraoral signs in mild cases
- Intraoral: abnormal labiolingual relationship between single or multiple teeth
22
Q
Anterior and posterior crossbite
How posterior crossbite diagnosed
A
- Clinical evaluation: A detailed examination of the patient’s bite and teeth alignment
- Study casts: Biometric analysis to assess the occlusion and tooth alignment
- Radiographic examination: Using orthopantomogram (OPG) and cephalometric X-rays
23
Q
Anterior and posterior crossbite
Types of deviation in occlusion seen in posterior crossbite
A
- Underdeveloped upper jaw w/ normal lower jaw
- Underdeveloped upper jaw w/ overdeveloped lower jaw
- Normal upper jaw w/ overdeveloped lower jaw
24
Q
Anterior and posterior crossbite
Prophylactic measures to prevent posterior crossbite
A
- Overcoming oral habits: Early intervention=>thumb-sucking or tongue-thrusting.
- Space maintainers: In cases of premature extraction of primary teeth, prevent crowding
- Extraction of overretained teeth: Primary teeth unable to naturally shed, after careful radiographic analysis
25
# Anterior and posterior crossbite
Treatment strategy for posterior crossbite
1. **Raising bite**: To correct occlusion and provide proper space for teeth alignment
2. **Creating space in dental arch**:achieved by either:
* **Expansion**: Widening dental arch
* **Distalization of teeth**: Moving teeth toward back of the mouth
* **Extraction**: Removing specific teeth to create necessary space
26
# Anterior and posterior crossbite
Appliances used for treating posterior crossbite in primary dentition
* **Interceptive appliances**: To correct oral habits
* **Lingual plate w/ screw**: Used to expand upper jaw and correct crossbite
* **Myogymnastic exercises**: To strengthen and guide proper muscle function
27
# Anterior and posterior crossbite
How posterior crossbite managed in mixed dentition
* **Overcoming oral habits**
* **Regular check-ups**=>monitor eruption of incisors,detect edge-to-edge tendencies/improper positioning
* Optimal time for intervention at initial eruption of maxillary incisors=>
* Especially if unresorbed primary teeth in posterior segment
28
# Anterior and posterior crossbite
Appliances groups used in mixed dentition for treating posterior crossbite
* **Removable appliances**: guide teeth into their correct positions gradually
* **Fixed appliances**: in more severe cases where more controlled movement of the teeth is required.
29
# Anterior and posterior crossbite
When treatment for posterior crossbite began in permanent dentition
* **Before eruption of the canines and second premolars**
* **Orthopedic expansion of maxilla** prior fusion of midpalatal suture- age 13-14
* Easier to expand upper jaw without surgical intervention
30
# Anterior and posterior crossbite
Two types of treatments for posterior crossbite in permanent dentition
* **Orthodontic treatment**: use of appliances such as *expanders, braces, or other orthodontic devices* to correct bite
* **Combined orthodontic-surgical treatment**: more severe cases, especially when maxillary deficiency=>
* **Midpalatal osteotomy** to expand upper jaw when orthodontic methods alone insufficient
31
# Anterior and posterior crossbite
Appliances used for treating posterior crossbite in permanent dentition
1. **Removable appliances**:
* **Lingual plate for upper jaw w/ screw and occlusal coverage**
* **Interceptive appliances** to address oral habits
* **Functional appliances**: correct function of jaw and teeth over time
2. **Fixed appliances**:
* **Edgewise technique**: form of fixed braces used for precise alignment of teeth
* **Intermaxillary elastics:** align upper and lower teeth
* **Expanders**: widen upper jaw=>
* **Rapid Palatal Expander (RPE):** expands upper jaw by applying pressure to midpalatal suture(orthopaedic force)
* **Quadhelix**: widen arch of maxilla
* **Transpalatal arch**: expands or stabilizes upper jaw
32
# Anterior and posterior crossbite
Rapid Palatal Expander (RPE):
* **Expands maxilla w/ orthopedic force**
* **Up to 12mm of expansion**
* Opens midpalatal suture
* Activation rate of RPE 1mm per day
* Used in cases of **maxillary deficiency syndrome**=>upper jaw too narrow
* **Haas RPE and Hyrax RPE**=>
* Hyrax RPE includes occlusal coverage to prevent interference w/ bite
* **NiTi expander**: Uses nickel-titanium to create continuous force for expansion
33
# Anterior and posterior crossbite
Recommended ages for using Rapid Palatal Expander (RPE)
* **Not recommended before age of 8** because midpalatal suture not yet developed to support effective expansion
* Most effective before midpalatal suture fuses=>around **13 to 14**
34
# Anterior and posterior crossbite
How expansion of maxilla achieved in permanent dentition
* **Tipping of posterior teeth buccally**: raising bite and moving upper posterior teeth outward
* **Opening midpalatal suture**: appliances like Rapid Palatal Expander (RPE) for bodily movement of posterior teeth=>
* Expands maxillary arch by widening suture between palatal bones
35
# Anterior and posterior crossbite
Risk associated with maxillary expansion in permanent dentition
* **Risk of relapse after treatment**=>
* If apical base of maxilla **smaller** than apical base of mandible
* Expanded maxilla reverts to original size or position, causing crossbite to return
36
# Anterior and posterior crossbite
Importance of raising the bite during treatment
* **Provide space for expansion of maxillary arch**
* **Reduce risk of interference between upper and lower teeth during correction process**
* Better alignment of teeth by improving vertical dimension of bite
37
# Anterior and posterior crossbite
Role intermaxillary elastics play in treatment
* **Small elastic bands** used in conjunction w/ fixed braces help **move upper and lower teeth into proper alignment**
* **Apply gentle, continuous pressure** to encourage teeth to move in desired direction
38
# Anterior and posterior crossbite
Two categories of Class I malocclusion with cross-bite?
* Anterior crossbite
* Posterior crossbite
## Footnote
Each category is defined by the specific teeth involved in the cross-bite.
39
# Anterior and posterior crossbite
Anterior crossbite
Involves one or two incisors
## Footnote
Anterior crossbite occurs when the upper incisors are positioned behind the lower incisors.
40
# Anterior and posterior crossbite
Posterior crossbite
Involves either single teeth or entire buccal segment
## Footnote
Posterior crossbite can affect one or more molars and can impact the overall bite.
41
# Anterior and posterior crossbite
Extraoral signs of anterior cross bite
Concave facial profile and a prominent chin
## Footnote
These signs indicate the external physical characteristics associated with anterior cross bite.
42
# Anterior and posterior crossbite
Intraoral signs of anterior cross bite
Anterior crossbite, gingivitis, and recessions
## Footnote
These signs represent intraoral conditions that may result from or be associated with anterior cross bite.
43
# Anterior and posterior crossbite
Functional issues associated with anterior cross bite
* Difficulty w/ normal mastication
* Issues w/ lateral mandibular movements
## Footnote
These functional problems can affect daily activities such as eating and speaking.
44
# Anterior and posterior crossbite
How upper arch length increased in the treatment of anterior crossbite
Through bite opening and proclination of upper incisors
## Footnote
This method involves adjusting the position of the upper front teeth to create more space.
45
# Anterior and posterior crossbite
Technique used to decrease lower arch length when treating anterior crossbite
Through retroclination of lower incisors
## Footnote
This technique involves tilting the lower front teeth backward to reduce the overall length of the lower arch.
46
# Anterior and posterior crossbite
Purpose of stimulating development of apical base in anterior crossbite treatment
*Support teeth alignment=>
* Particularly frontal segments
## Footnote
Enhancing the apical base helps create a more stable foundation for the teeth.
47
# Anterior and posterior crossbite
One key aspect to control during mixed dentition checkups
Controlling eruption of incisors
## Footnote
Ensuring no edge-to-edge tendencies or improper inclinations
48
# Anterior and posterior crossbite
Assessed to prevent worsening of crossbite
Crowding
## Footnote
Identifying space available for teeth and addressing crowding early
49
# Anterior and posterior crossbite
Prophylactic appliances uses in primary dentition
To correct oral habits, such as thumb sucking or tongue thrusting
## Footnote
Prophylactic appliances help in preventing further dental issues by addressing harmful habits.
50
# Anterior and posterior crossbite
Purpose of a lingual plate w/ occlusal coverage and screw
To procline upper segment of teeth
## Footnote
This appliance is used to reposition teeth in the upper arch for better alignment.
51
# Anterior and posterior crossbite
Chin cup use
Addresses jaw growth discrepancies
## Footnote
The chin cup is a functional appliance that influences the growth of the mandible.
52
# Anterior and posterior crossbite
Functional appliances use
Guide jaw and tooth development
## Footnote
Functional appliances are designed to modify the relationship between the teeth and the jaw.
53
# Anterior and posterior crossbite
Issue addressed by i-3 trainer
*Crossbite issues=>
* Aligns bite and addresses habits
## Footnote
The i-3 trainer helps in correcting the bite while also focusing on patient habits that may affect dental alignment.
54
# Anterior and posterior crossbite
Conditions associated with underdevelopment of the upper jaw
* Cleft lip and palate
* Mouth breathing (causing compression)
* Genetic or congenital factors
## Footnote
These factors can contribute to the underdevelopment of the upper jaw.
55
# Anterior and posterior crossbite
Conditions associated with underdevelopment of the lower jaw
* Hypodontia
* Inherited traits
## Footnote
These factors can contribute to the underdevelopment of the lower jaw.
56
# Anterior and posterior crossbite
Conditions associated with overdevelopment of upper jaw
* Overretained primary teeth
* Supernumerary teeth
* Hereditary traits
## Footnote
These factors can contribute to the overdevelopment of the upper jaw.
57
# Anterior and posterior crossbite
Conditions are associated with overdevelopment of the lower jaw
* Macroglossia
* Hereditary traits
* Overretained primary teeth
## Footnote
These factors can contribute to the overdevelopment of the lower jaw.
58
# Anterior and posterior crossbite
Primary goal of raising the bite in treating posterior cross bite
* Correct occlusion
* Provide proper space for teeth alignment
## Footnote
Raising the bite helps in achieving a balanced bite and can alleviate issues related to cross bites.
59
# Anterior and posterior crossbite
Methods for creating space in dental arch
* Expansion
* Distalization of teeth
* Extraction
## Footnote
Creating space is essential for proper alignment of teeth and can involve various orthodontic techniques.
60
# Anterior and posterior crossbite
Fill in the blank: _______ involves widening the dental arch.
[Expansion]
## Footnote
Expansion is a common orthodontic treatment to address crowding and improve occlusal relationships.
61
# Anterior and posterior crossbite
What does distalization of teeth refer to?
Moving teeth toward the back of the mouth
## Footnote
Distalization can help create space in the dental arch and improve overall dental alignment.
62
# Anterior and posterior crossbite
When treatment for posterior crossbite began in permanent dentition
Before eruption of the canines and second premolars
## Footnote
This timing allows for more effective treatment options.
63
# Anterior and posterior crossbite
Recommended age for orthopedic expansion of maxilla
Age 13-14
## Footnote
This is prior to the fusion of the midpalatal suture.
64
# Anterior and posterior crossbite
Why easier to expand upper jaw before a certain age
Easier to expand upper jaw without surgical intervention
## Footnote
This is due to the flexibility of the skeletal structures before full maturation.
65
# Anterior and posterior crossbite
Name a type of removable appliance used for posterior cross bite.
Lingual plate for upper jaw w/ screw and occlusal coverage
66
# Anterior and posterior crossbite
What are interceptive appliances used for?
To address oral habits
67
# Anterior and posterior crossbite
What is the purpose of functional appliances?
Correct function of jaw and teeth over time
68
# Anterior and posterior crossbite
Technique used in fixed appliances for precise alignment of teeth
Edgewise technique
69
# Anterior and posterior crossbite
Intermaxillary elastics uses
Align upper and lower teeth
70
# Anterior and posterior crossbite
Function of expanders in orthodontics
Widen upper jaw
71
# Anterior and posterior crossbite
Rapid Palatal Expander (RPE) function
*Expands upper jaw=>
* Applies pressure to midpalatal suture
72
# Anterior and posterior crossbite
Quadhelix use
Widen arch of maxilla
73
# Anterior and posterior crossbite
Transpalatal arch use
Expands or stabilizes upper jaw
74
# Anterior and posterior crossbite
When combined orthodontic-surgical treatment indicated
More severe cases, especially when maxillary deficiency is present
## Footnote
This approach is necessary when orthodontic methods alone are insufficient.
75
# Anterior and posterior crossbite
Surgical procedure performed to expand upper jaw in severe cases of posterior crossbite
Midpalatal osteotomy
## Footnote
This procedure is used when orthodontic methods alone are insufficient to correct the crossbite.
