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    Anterior Cross Bites in Primary Mixed Dentition Pedo

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    rajputjp
    1. Anterior crossbite can be caused by dental factors like traumatic injuries, skeletal factors like deficient maxillary growth, or functional habits. 2. Treatment for anterior crossbite in primary dentition focuses on eliminating causative factors. In mixed dentition, early treatment is important to prevent worsening malocclusion. 3. Management options include tongue blades, Catlan's appliances, springs, and screws to align individual teeth or segments. For skeletal crossbites, face masks or chin caps are used. Functional appliances like Frankel III can also be used.

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    Anterior Cross Bites in Primary Mixed Dentition Pedo

    Uploaded by

    rajputjp
    2K views32 pages
    1. Anterior crossbite can be caused by dental factors like traumatic injuries, skeletal factors like deficient maxillary growth, or functional habits. 2. Treatment for anterior crossbite in primary dentition focuses on eliminating causative factors. In mixed dentition, early treatment is important to prevent worsening malocclusion. 3. Management options include tongue blades, Catlan's appliances, springs, and screws to align individual teeth or segments. For skeletal crossbites, face masks or chin caps are used. Functional appliances like Frankel III can also be used.

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    1. Anterior crossbite can be caused by dental factors like traumatic injuries, skeletal factors like deficient maxillary growth, or functional habits. 2. Treatment for anterior crossbite in primary dentition focuses on eliminating causative factors. In mixed dentition, early treatment is important to prevent worsening malocclusion. 3. Management options include tongue blades, Catlan's appliances, springs, and screws to align individual teeth or segments. For skeletal crossbites, face masks or chin caps are used. Functional appliances like Frankel III can also be used.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    2K views32 pages

    Anterior Cross Bites in Primary Mixed Dentition Pedo

    Uploaded by

    rajputjp
    1. Anterior crossbite can be caused by dental factors like traumatic injuries, skeletal factors like deficient maxillary growth, or functional habits. 2. Treatment for anterior crossbite in primary dentition focuses on eliminating causative factors. In mixed dentition, early treatment is important to prevent worsening malocclusion. 3. Management options include tongue blades, Catlan's appliances, springs, and screws to align individual teeth or segments. For skeletal crossbites, face masks or chin caps are used. Functional appliances like Frankel III can also be used.

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    DEPAR

    TMENT
    OF
    PAEDIA
    TRIC
    ANTERIOR
    CROSS BITE
    in primary and mixed
    dentition
    INTRODUCTION

    • DEFINITION

    According to Graber:
    Cross bite is a condition where one
    or more teeth may be abnormally
    malposed buccaly or lingually or labially
    with reference to opposing teeth.
    Etiology of
    anterior cross bite
    in primary and mixed
    dentition
    classification Based on the Etiologic Factor

    ANTERIOR Cross
    bite

    Dental Skeletal Functional


    Cross bite Cross bite Cross bite
    Causes of anterior cross bite

    • Dental causes
    • Skeletal causes
    • Causes of Functional cross bite
    Dental causes
    1. Traumatic injury to primary
    dentition causes lingual
    displacement of permanent tooth
    bud

    • Persistance of a deciduous tooth

    • Palatal deflection of its erupting


    successor

    • Single tooth anterior cross bite.


    2. supernumerary tooth.
    3. Habit of biting upper lip.
    4. Cleft lip repair cases.
    5. Arch length inadequacy.

    Causing lingual deflection of


    permanent tooth during
    eruption.
    Skeletal causes

    1. Genetic.
    2. Due to deficient
    anterior growth of
    maxilla.
    3. Excessive abnormal
    mandibular growth in
    anterior region.
    4. Combination of both 2
    and 3.
    Causes of functional cross bite

    1. Habitual forward
    positioning of the
    mandible to obtain
    maximum
    intercuspation may
    lead to an anterior
    cross bite.
    2. Pseudo class Ⅲ.
    1.Anterior cross bite due to
    maxillary retrognathism.

    2.Anterior cross bite due to


    mandibular prognathism.

    3.Anterior cross bite due to


    maxillary retrognathism and
    mandibular prognathism.
    Types of anterior
    cross bite

    • Ectopic incisors
    • Skeletal class Ⅲ malocclusion
    • Pseudo class Ⅲ malocclusion
    Ectopic incisors

    # An incisor may erupt ectopically either


    palatally in the maxilla or labially in the
    mandible to a cross bite relationship in
    centric occlusion. This may occur in the
    child with a balanced skeletal relationship.
    # Early treatment is only necessary, if
    there is a deviation on opening and or
    closing or if there is a traumatic occlusion
    or periodontal concern.
    Skeletal class Ⅲ malocclusion
    # An anterior cross bite may be associated
    with a skeletal class Ⅲ discrepancy such
    that, although the incisors are positioned
    correctly within the alveolar ridges, they
    are in negative overjet on closing into
    centric occlusion with no deviation of
    mandibular closure.
    Pseudo class Ⅲ malocclusion

    # This pattern occurs where there is a habitual


    mandibular closure pattern such that the mandible
    goes into a protrusive bite and thus cross bite of
    incisors avoiding traumatic occlusion with lingual
    position of one or more maxillary incisors. Thus
    anterior shift of the mandible can affect the
    growth of both the maxilla and the mandible with
    undesirable muscle adaptation.
    Single tooth anterior Segmental anterior cross
    cross bite bite
    Management of
    anterior cross bite in primary
    and mixed dentition
    [I] IN PRIMARY DENTITION
    Elimination of the factors that may lead to
    the anterior cross bite
    E.g.
     Removal of occlusal prematurities.
     Extraction of supernumerary tooth,
    before they cause displacement of other
    tooth.
     Habit breaking appliance.
    [II] IN MIXED DENTITION:
    (In pre-adolescent age group)

    Anterior cross bite should be treated at


    an early stage.
    Because
    1.If a cross bite present in the deciduous
    dentition, it may manifest in the mixed
    & permanent dentition as well.
    2.if simple anterior cross bite is not
    treated in early stage it may
    progress into skeletal malocclusion that
    later needs complicated orthodontic or
    surgical treatments.
    (1) Use of tongue blade

    Indications
     Used when a cross bite is seen at the time the
    permanent teeth are making an appearance in
    the oral cavity.
     It is placed inside the mouth contacting the
    palatal aspect of the maxillary teeth.

    Upon slight closure of jaw the opposing side of


    the stick come in contact with the labial aspect
    of the opposing mandibular tooth acts as a
    fulcrum.

    This is continued for 1-2 hours for about 2


    weeks.
    Drawbacks of using tongue blade
     Only effective till the clinical crown not
    completely erupted in the oral cavity.
     Used only if sufficient space is available for
    the correction.
     Patients cooperation is required.
    (2) Catlan’s appliance or lower anterior inclined
    plane

    Indications
    - Used only in those cases
    where the cross bite is
    due to a palataly placed
    max incisors.
    (Constructed at 45
    degree angulations on the
    lower anterior teeth by
    acrylic or cast metal).
    Disadvantages of Catlan’s Appliance
    1) Difficulty in speech & chewing
    2) Patient cooperation required
    3) Require frequent recementation
    4) Catlance appliance also as a anterior bite plane
    Prevent the posterior teeth from coming into contact
    If prolonged use,
    Supra eruption of posterior teeth
    causes Anterior open bite.
    5) Can not be given if Mandibular incisors are malaligned
    and are periodontally compromised.
    [3] Double cantilever spring / z-spring

    Indication
    Used when anterior cross bite
    Pre-treatment
    involving 1 or 2 max. anterior
    teeth.
    Disadvantage
    During treatment
    Effective only when there is
    enough space for aligning the
    teeth.
    Post-treatment
    (4) Screw appliance

    Micro screw
    • Used on individual tooth
    • Multiple micro screw
    can be used to correct
    individual tooth in
    segmental cross bite
    Mini screw
    • Capable of moving up to
    2 teeth
    Medium screw
    Used to correct
    segmental cross bite

    3-D screw
    (3dimensional screw)
    Capable of correcting
    posterior as well as
    anterior cross bite
    [5] Face mask (or face mask along with RME)

    Indications
    Used to correct skeletal anterior cross bite (Anterior cross bite due to actual
    skeletal deficiency of the maxilla
    Protraction face mask or Reverse head gear

    If maxilla is narrow
    RME screw also used for transverse expansion.
    [6] Chin cap appliance

     Used to correct or prevent


    the anterior cross bite due
    to a prominent mandible.
     Chin cap appliance rotate
    mandible backward and
    downward.
    [7] Frankel III appliance

    Used to correct skeletal class


    III Malocclusion.
    Conclusion

    As the incidence of cross bite in primary


    & mixed dentition increases patients having
    functional & esthetic problems are becoming
    more common in dental practice.
    These patients requires special attention
    with regard to functional & cosmetic
    problems in primary stage because if they
    are ignored, later they may require more
    complicated treatment.
    In addition to good oral health promotion
    there is increased need for collaboration
    between dental & cosmetic professionals to
    provide safe and appropriate dental care for
    these patients.
    references

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