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Cross Bite

INDIAN DENTAL ACADEMY Leader in continuing dental education

Introduction It is a term used to describe abnormal occlusion in the transeverse plane ď Ž A Cross bite represents the disturbances in the bucco palatal or labio lingual direction when brought into occlusion ď Ž

Classification of cross bite ď Ž

A. Anterior Cross Bite 1.Single tooth 2.Segmental B . Posterior Cross Bite 1.Unilateral 2.Bilateral C. Based on the nature of bite as: 1. Skeletal 2. Dental 3. Functional cross bite

Etiology of Cross Bite     

Retained deciduous tooth Crowding and abnormal displacement of one or more teeth Presence of habits such as thumb sucking Retarded growth of maxilla in both sagital as well as vertical direction Narrow upper arch due to decreased growth stimulation in the mid palatal suture

Collapse of maxillary arch as seen in cleft palate

Sagital discrepancy of the jaws

Unilateral hypo or hyperplastic growth of any jaw

Anterior cross bite Reverse overjet is seen ď Ž - single tooth or segmental ď Ž

Posterior Cross Bite Abnormal transverse relationship between upper and lower post teeth ď Ž Lack of co-ordination in the lateral dimension between upper and lower arches. ď Ž

Buccal non-occlusion-Maxillary posterior occlude entirely on the buccal aspect of mandibular posteriors -Scissors Bite

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Skeletal Cross Bite ď Ž

It occurs as a result of mal position or malformation of the jaws

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Generally characterized by narrow maxillary arch

Dental Cross Bite ď Ž

Results due to localized disturbances -Ectopic eruption of permanent tooth -Over retained deciduous tooth

Functional Cross Bite Presence of occlusal interferences result in deviation of mandible during jaw closure – Unilateral Cross Bite

Habitual forward positioning of the mandible

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Lingual non- occlusion Maxillary posteriors occlude entirely on the lingual aspect of mandibular teeth

Differential diagnosis between skeletal and dental cross bite - Dental origin usually exhibits abnormal buccal or lingual axial inclination - Symmetry of dental arches on diagnostic study model - Determine if there is any lateral shift of the mandible during closure

Dentoalveolar Crossbite with good apical base width

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Cross Bite with deficient apical base width

Treatment In primary dentition If the inter molar width is satisfactory - Elimination of deflective occlusal contacts If both molar and inter canine widths are narrow -Expansion of upper arch is indicated

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Early Mixed dentition -Anterior Cross Bite  Extracting the primary teeth if there is not enough space  If sufficient space is present Removable appliance is given 

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Posterior cross bite Removable or fixed appliance

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Late mixed dentition Maxillary arch expansion -Skeletal: opening the mid-palatal suture -Dental : fixed or removable appliance Single tooth cross bites: cross elastics are used Leader in continuing dental education

Cross bite2/ dental implant courses by Indian dental academy  

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