Anterior Crossbite

Question 1

General treatment considerations ACB

Answer 1

Posterior expansion and anterior proclination will be required to create space to procline the tooth in crossbite and align it in the arch.

IPR may also be required if additional space is needed.

Question 2

Full anterior crossbite

Answer 2

When all anterior teeth are in crossbite, differential diagnosis is needed to determine whether the crossbite is caused by a functional shift due to anterior interferences vs. a true skeletal problem.

The full Anterior Crossbite will be more easily corrected when the anterior interference is removed by proclining the upper anterior teeth, retroclining the lower anterior teeth or a combination of both.

Class III elastics may also be needed if additional inter-arch correction is needed.

Question 3

Note on ACB

Answer 3

Since the aligners cover the anterior and posterior teeth, anterior crossbite correction is easily accomplished without needing any additional measures to allow the tooth/teeth in crossbite to “jump” over the opposing teeth.

Question 4

ACB Simple

Answer 4

Lingually tipped teeth that can be proclined.

Number of teeth involved in the Crossbite: 1

Question 5

ACB Intermediate

Answer 5

Lingually tipped teeth that can be proclined

Number of teeth involved in the Crossbite: 2

Question 6

ACB Complex

Answer 6

Little to no possibility to plan for anterior proclination

Number of teeth involved in the Crossbite: More than 2

Question 7

ACB Prescription Form

Answer 7

Anterior Crossbite will always be corrected by default - except in case of full Anterior Crossbite due to Class III if you have requested to not solve the Class III.

The options you have selected at question 10 to solve the crowding issues will also be used to align the arches and solve the crossbite.

Note: If you haven’t specified which options to use, the software will plan for proclination, then expansion, then IPR.

You can provide specific indications through the Special Instruction field.

(Choose Expand and Procline “as needed” in Q10 on Rx Form)

Question 8

ACB ClinCheck Review

Answer 8

It is important to review both crown and root movements when programming Anterior Crossbite correction to ensure there is adequate buccal root torque on the tooth in question. Review ClinCheck treatment plans to confirm that both the crowns and roots are well aligned and the roots are not left under-torqued.

Question 9

ACB Monitoring

Answer 9

During the treatment, a posterior open bite will occur while the tooth is in transition to its final position. This is not represented in the ClinCheck plan, thus you will observe a discrepancy in terms of occlusion between the ClinCheck stage and the actual clinical situation.