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Crossbite

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contributed by Anahita Gupta:

A crossbite is an irregularity of the occlusal surface of the tooth. It occurs when one or more teeth have a buccal (Mandibular teeth) or lingual (Maxillary teeth) position when compared to its matching tooth above or below it.

Crossbite Example

The crossbite can be:-

  1. “Anterior”, with a negative overjet, also known as a class III skeletal abnormality or prognathism.
  2. “Posterior” crossbite, with a narrow maxillary bone and a narrow upper dental arch.
  3. Crossbite can also be either unilateral or bilateral.

Crossbite

Etiology:

  1. 1.     Hereditary/Genetic- This usually presents as a wide lower jaw thus affecting the entire dentition.
  2. 2.     Delayed loss of Deciduous teeth- This usually presents as a single tooth cross.
  3. 3.     Abnormal path of eruption
  4. 4.     Thumb sucking can contribute to a crossbite by constricting the width of the palate and deforming the upper bone of the palate.

 

Symptoms:


  1. Painful chewing and a painful jaw and teeth.
  2.  It can also affect chewing in such a way that the temporomandibular joint gets inflamed. This inflammation causes pain in the TMJ and sometimes headaches.

 

Complications:

  1. Periodontitis and gingivitis
  2. Tooth loss due to malocclusion
  3. Degeneration of the temporomandibular joint, causing arthritis of the TMJ and wearing away of the joint surface. This can result in the need for surgery to replace the TMJ completely.

 

Crossbite prevention:

  1. 1.     
You can prevent a crossbite by stopping thumb sucking early in life so the upper palate doesn’t become narrowed and malformed.
  2. 2.     You can have the deciduous teeth extracted when the permanent are about to erupt.
  3. 3.     Many types of crossbite, however, cannot be prevented and must be treated when noted.

 

Treatment options:

Orthodontists need to treat a crossbite as soon as possible so that the teeth can be realigned. If mouth breathing is part of the cause, a tonsillectomy and adenoidectomy should be performed before the patient undergoes orthodontic therapy.

I) The first part of treatment involves maxillary expansion. It widens the jaw when worn nightly for a couple of months. A key turns the device and gradually increases the width of the palate.

II) After the palate has expanded enough, orthodontic devices are necessary to straighten the teeth. This means a full set of braces for a total of one to two years in order to create an ideal bite.

 



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