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Main Instructor Kai-Sheng Lu
Wen-Ken Tai
Chih Chen Chou
Chia-Tze Kao
Department / Institution 1.Orthodontic Department, Chung Shan Medical University Hospital
2. School of Dentistry, College of Oral Medicine, Chung Shan Medical University
Classification Case report
Anterior cross bite can be differential diagnosed as skeletal Class III malocclusion and Pseudo class III malocclusion. The aim of this case report is to describe how to treat a clinical case with Pseudo Class III malocclusion treated by non-extraction fixed appliance. With accurate diagnosis and clinical assessment, the treatment results showed an apparent improvement in both facial harmony and occlusion.
A 8 years-old male patient in mixed dentitions stage was referred for treatment of anterior crossbite. Extra orally, facial evaluation revealed a slight retrusion of the upper lip with excessive mandibular anterior displacement. The intraoral examination showed a crossbite of two permanent central incisors and unerupted lateral incisors. Patient also showed a functional shift of occlusion. The cephalometric x ray confirmed with proclined lower incisors and skeletal patterns of normodivergency.
 The treatment goal is to increase maxilla arch length and reduce the functional shift. Patient was intiated with the installation of a fixed appliance. The total active treatment was about25 months. After completion of the treatment, the anterior cross bite was corrected with harmonious facial appearance.
Anterior cross bite without skeletal problem requires early intervention to achieve a normal occlusion. In the case of pseudo-Class III malocclusion, the various treatment can approach, including fixed and expansion appliance, face mask, chin cap and removable appliance. All these appliances can be used in early mixed dentition period. In addition to the growth pattern and treatment decision should consider the number of malpositioned teeth, the degree of overjet and overbite ,and the parents for the treatment. Comparing to removable appliances ,the simple fixed appliance allows three dimensional tooth movement which can correct crossbite , the rotated teeth and diastema with favorable control of angulation and inclination
Early Treatment of Anterior Cross Bite