Anterior cross bite



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charming

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ANTERIOR CROSS BITE

« on: July 28, 2012, 05:44:01 PM »



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HI,


my patient has anterior crossbite. During the level and alignment, i put a ketac molar filling on 36 and 46 occlusal surface open the occlusion. but my patient has grinding problem and ketac keep wearing off, any other option to disocclude the bite? usually how long it will take for the teeth to bouch out from crossbite?

can anybody help???

Thank you










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Marta

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Re: ANTERIOR CROSS BITE

« Reply #1 on: July 29, 2012, 12:05:30 AM »



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Hi Charming: 

any other option to disocclude the bite?......... Usually would wait for at least 5 months for the upper teeth to jump over the lowers, with only brks. But in this case maybe is a good idea to help that bite with a lower splint, stronger. The patient has to wear it 24 hours/day except for eating. Had just finished a case with only a #12 in x-bite, but the patient was braquifacial, strong muscles and had to use the splint, cause after that time #12 was still in x-bite.

See you have no brcks #34+44, so guess you are going to extract them. Were you told to not extract them jet?. If not, would extract all teeth planned ASAP, once you have placed upper and lower brcks.

Hope this helps.............Marta smiley








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ABuck

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Re: ANTERIOR CROSS BITE

« Reply #2 on: July 29, 2012, 02:59:49 AM »



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Hi,
if the patient wears the splint its a good idea, but maybe difficult to make as you have brackets on the teeth. 


Try putting cetac on the molars and premolars, more work but slower wareing. If it does not work use composit, which should withstand the forces of abrasion but will give you a harder time taking it off again. Or maybe a different colored compomer like Band Lock (3M) which is blue. 
As you want to jump the bite and establish more upper torque I would not put the archwire in the lower. Leaving the archwire might procline the lower, then the upper teeth must chase the lower and overtake as well. A lot harder to do!
As Marta wrote if your tx plan is ex, in lower you might want to do this now. For one the lower crowding will dissipate into the ex space and less into proclination which helps jumping the bite plus the #41 looks long and maybe should not be proclined for perio reasons?
You might wait in the upper with ex as this will help proclining the upper and establishing positive overjet for cl 2 correction and torque. 
Best regards
ABuck




« Last Edit: July 29, 2012, 03:02:15 AM by ABuck »

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Mike

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Re: ANTERIOR CROSS BITE

« Reply #3 on: July 29, 2012, 04:13:53 AM »



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Usually a patient never wears 24h unless you cement it. Proposal .










As mentioned by Marta and Andrew already :


-start upper arch first as the more the lower levels, the more the teeth procline, the more difficult to correct the x-bite
- if you plan extractions in the lower and relief of crowding is one of the reasons, then extract at the beginning and allow levelling in x-space.
Regards Mike



















Marta

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Re: ANTERIOR CROSS BITE

« Reply #4 on: July 29, 2012, 11:25:06 AM »



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Hi ALL: 


Andrew……. Yes, you are right. In this cases the splint is a bit different than the one for bruxism. Only need upper + lower impression + bite. The splint only covers the teeth on the lingual and occlusal surface. There is no acrylic on the labial, only 4 hooks (between 5s-6s and 2s-3s). Sorry am at home so do not have a photo handy. Will post it tomorrow. 

Mike……..yeah! you are very right too. When ever I use it, have to make sure the patient understands, it is CRITICAL to use it 24 hours/day (except for eating), if they want the teeth to jump and align. Just like we do with elastics. …..........Marta smiley









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Marta

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Re: ANTERIOR CROSS BITE

« Reply #5 on: July 31, 2012, 05:13:32 AM »



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Hi:


Sorry am having problems with my camera, maybe need a new one...AG! sad
Here are the photos if can be of any help.Was wrong, as you can see the hooks go between 3s-4s-5s…….. Marta smiley















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