Open Access

Self correction of anterior crossbite: a case report

Cases Journal20092:6967

https://doi.org/10.4076/1757-1626-2-6967

Received: 29 March 2009

Accepted: 24 June 2009

Published: 14 July 2009

Abstract

A 9-year-old Chinese boy presented with an anterior crossbite, no treatment was performed at that time because the incisors have open root apices. The crossbite self-corrected after one year. This case demonstrated that an anterior crossbite may self-correct without treatment.

Introduction

An anterior crossbite is the description of the upper anterior teeth having one or more occlusions at the lingual side of the lower anterior teeth. According to Lin JJ, the prevalence of anterior crossbite was 13.83% in a Taiwanese sample of 7090 elementary and junior high school students. Aged 9 to 15 years old [1]. The presence of anterior crossbites may cause mandibular displacement, if left untreated may lead to restriction of maxillary growth, traumatic occlusion, and may lengthen the treatment time.

Case presentation

The patient was 9-year-old Chinese boy, was brought to our hospital by his mother to seek treatment for his "wrongly positioned front tooth". His medical and dental histories were non-contributory. On extra-oral examination, his face was symmetrical with a slightly convex lateral profile. Intra-orally the tooth 11 was tipped disto-palatally and was in crossbite with the tooth 42 (Figure 1). Functional mandibular shift was not detected. Radiographic examination showed all permanent teeth developing normally. However teeth 11 and 21 still have wide open root apices (Figure 2). It was reported that orthodontic treatment of a tooth with an open root apex would produce early closure of the apex, resulting in a short-rooted tooth [2]. Therefore, it was decided to wait until the roots of the upper incisors were more developed before correcting the anterior crossbite. After one year the patient returned for review. The crossbite had improved and teeth 11 and 42 became edge to edge (Figure 3). However there was slight recession of tooth 42 possibly due to occlusal trauma (Figure 4). Since the crossbite was improving, it was decided to keep the case under observation.
Figure 1

Tooth 11 in crossbite with tooth 42.

Figure 2

Apices of teeth 11 and 21 were still wide open.

Figure 3

Tooth 11 in edge to edge position with tooth 42.

Figure 4

Buccal gingival recession of tooth 42 resulted from traumatic occlusion between teeth 11 and 42.

The case was followed up to permanent dentition. A palatal arch type space maintainer was placed to minimise space loss in the upper arch. The crossbite further self-corrected to normal overbite and overjet. The gingival condition of 42 improved (Figure 5). Apices of teeth 11 and 21 were fully developed with normal root lengths (Figure 6). The band on tooth 16 (Figure 6) was the space maintainer.
Figure 5

Anterior crossbite between teeth 11 and 42 corrected with normal overbite and overjet.

Figure 6

Root apex of tooth 11 matured with normal length.

Discussion

An anterior crossbite may cause mandibular displacement which leads to various dental problems. Early correction of the anterior crossbite may facilitate the eruption of canines and premolars into Class I [3], eliminates traumatic occlusion to the incisors [4, 5] (which may lead to dehiscence and gingival recession), providing a normal environment for growth of the maxilla [6], and can often improve the self esteem of the child [7]-[9]. Therefore early correction of the crossbite is indicated. In this case, correction of the anterior crossbite was postponed in view of the open apex. The crossbite subsequently self-corrected. It should be noted that this is not common. It is usually necessary to correct the crossbite by orthodontic means as an interceptive measure and this case was an exception to this general condition. It is possible that the tongue may have proclined the incisor, as there was space to allow this to occur.

Consent

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Declarations

Authors’ Affiliations

(1)
Orthodontics, Faculty of Dentistry, The University of Hong Kong

References

  1. Lin JJ: Creative Orthodontics Blending the Damon System & TADs to manage difficult malocclusions. Edited by: Chang Ho-Hua. 2007, Yong Chiem, 17-26. 1Google Scholar
  2. Hendrix I, Carels C, Kuijpers-Jagtman AM, Van 'T Hof M: A radiographic study of posterior apical root resorption in orthodontic patients. Am J Orthod Dentofacial Orthop. 1994, 105: 345-349. 10.1016/S0889-5406(94)70128-8.View ArticlePubMedGoogle Scholar
  3. Rabie AB: Diagnostic criteria for pseudo-Class III malocclusion. Am J Orthod Dentofacial Orthop. 2000, 117: 1-9. 10.1016/S0889-5406(00)70241-1.View ArticlePubMedGoogle Scholar
  4. Major PW, Glover K: Treatment of anterior crossbite in early mixed dentition. J Can Dent Assoc. 1992, 58: 574-575.PubMedGoogle Scholar
  5. Rakosi T, Schilli W: Class III anomalies: a coordinated approach to skeletal, dental and soft tissue problems. J Oral Surg. 1981, 39: 860-870.PubMedGoogle Scholar
  6. Kapur A, Chawla HS, Utreja A, Goyal A: Early class III occlusal tendency in children and its selective management. J Indian Soc Pedod Prev Dent. 2008, 26: 107-113. 10.4103/0970-4388.43191.View ArticlePubMedGoogle Scholar
  7. Shaw WC, Meek SC, Jones DS: Nicknames, teasing, harassment and salience of dental features among school children. Br J Orthod. 1980, 7: 75-80.View ArticlePubMedGoogle Scholar
  8. Shaw WC: The influence of children's dentofacial appearance on their social attractiveness judged by peers and lay adults. Am J Orthod. 1981, 79: 399-415. 10.1016/0002-9416(81)90382-1.View ArticlePubMedGoogle Scholar
  9. Campbell PM: The dilemma of Class III treatment/early or late?. Angle Orthod. 1983, 53: 175-191.PubMedGoogle Scholar

Copyright

© licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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