Cross bite

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CROSS BITE
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• Condition where one or more teeth may be
  abnormally malposed buccally or lingually or
  labially with reference to the opposing tooth or
  teeth.

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Classification

• Based on location-
• Anterior crossbite
• 1. single tooth
• 2.segmental
• Posterior crossbite
• 1. unilateral
• 2. Bilateral

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• Based on nature
• skeletal
• Dental
• Functional

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• Buccal non occlusion Maxillary posteriors
  occlude entirely on the buccal aspect of the
  mandibular posteriors.
• Lingual non occlusionMaxillary posteriors
  occlude entirely on the lingual aspect of the
  mandibular posteriors.

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Anterior crossbite

• Lingual position of maxillary anterior teeth in
  relationship with the mandibular anterior teeth.

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Posterior crossbite

• This refers to abnormal transverse relationship
  between the upper and lower posterior teeth. In
  this condition ,instead of mandibula buccal cusps
  occluding in the central fossae of the maxillary
  posterior teeth ,they occlude buccal to the
  maxillary buccal cusps.

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• Skeletal crossbite is associated with a
  discrepancy in the size or the position of the
  maxilla and the mandible.
• May be found in the anterior or posterior region.

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Dental cross bite

• Dental crossbite are usually localized conditions
  where one or more teeth are abnormally related to
  that of the opposing arch.

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Functional crossbite

• Presence of occlusal interference can result in
  deviation of the mandible during jaw closure.This
  can result as a unilateral posterior crossbite.
• Habitual forward positioning of the mandible
  (pseudo classIII) may lead to an anterior
  crossbite.

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Etiology

• Retained deciduous teeth
• ALTM (Arch length tooth material) discrepancy
• Habits such as thumb sucking ,mouth breathing.
• Retarded development of the maxilla in sagittal
  and transverse direction.
• Forwardly positioned mandible or mandibular
  prognathism.

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MANAGEMENT

• Anterior crossbite
• -Tongue blade therapy
• -Catlans appliance
• Use of z spring
• Fixed appliance
• Management of skeletal crossbite during growth
  period.

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Use of tongue blade therapy

• Developing single tooth cross bite.
• Sufficient space.
• Tongue blade is placed inside the mouth
  contacting the palatal surface of the tooth in
  crossbite.
• The blade is made to rest on the mandibular tooth
  in crossbite which acts as a fulcrum and the
  patient is asked to rotate the oral part of the
  blade upwards and forwards.

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Catalans appliance or lower anterior inclined
plane

• Used to treat maxillary teeth in crossbite.
• Acrylic or cast metal
• Single tooth or segment of the upper arch in
  crossbite.
• 45 degree angulation which forces the maxillary
  teeth in crossbite to a more labial position.

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Disadvantages

• Speech problem
• Dietary restrictions
• If used for more than 6 weeks it can result in
  anterior open bite.
• May need frequent recementation.

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Double cantilever spring

• Cross bite involving one or two maxillary teeth.

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Disadvantages

• Speech problem
• Dietary restrictions
• If used for more than 6 weeks it can result in
  anterior open bite.
• May need frequent recementation.

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POSTERIOR CROSSBITE

• Cross elastics
• Expansion of the upper arch
• -Coffin spring
• -Quadhelix
• -RME
• Fixed appliances.

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Cross elastics

• Single tooth crossbite involving the molars can
  be treated using elatics that are streched
  between the maxillary palatal surface and
  mandiular buccal surface.

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• Thank you