Bite or occlusion is the position of the teeth of the upper and lower jaw at the time of the closing. Normally during the process of closing the upper dentition overlaps the lower one by(for) one third. A deviation from the norm is called an occlusal anomaly or malocclusion. Cross bite is a bite pathology in which the overlap between the upper and lower teeth is disrupted so that in some parts or single teeth of the lower jaw are covered the corresponding upper teeth. If the overlap is broken at least in the area of one tooth, then this is already considered a cross bite or cross ratio in the area of one tooth.
Crossbite in the lateral section
Crossbite in the anterior sectionе
Crossbite is classified according to several factors:
An irregular crossbite is primarily determined visually. When the jaws are closed, individual teeth or groups of teeth in the lower arch overlap the corresponding teeth in the upper arch. The upper and lower teeth seem to "intersect" with each other.
Indirect symptoms of crossbite are facial asymmetry and chin displacement. These signs do not always appear, and if they do, they do not necessarily indicate a crossbite.
Crossbite is also associated with physical discomfort when teeth cling to each other. However, bite anomalies usually develop gradually throughout life, so a person gets used to the inconvenience and does not notice them.
Most often, bite pathology is formed from the early childhood during primary teeth or the change of baby teeth to permanent ones. The bite is formed both under the influence of factors independent of a person: the structural features and development of the jaws and teeth, and because of the child's bad habits or improper dental care.
In adults, crossbite can be formed by facial trauma or poor quality prosthetics. While restoring teeth with crowns or veneers, it is important to take into account the anatomically correct position and size so that the orthopedic appliance does not interfere with the natural bite of the teeth.
Malocclusion can develop into two forms, which affect the duration and technology of treatment.
Malocclusion at the level of the teeth is usually corrected more quickly. Sometimes it is enough to work with a bad habit or to grind the canines. Surgery may be required to correct the skeletal abnormality.
The skeletal shape of a malocclusion can be determined visually.
Assess the position of the jaws when the mouth is opened. The midline of the upper and lower dentition should match. If the teeth slip and get into the wrong position only when they are closed, this is a pathology at the level of the teeth.
If the jaws and teeth visually stand crooked relatively to each other, even when the teeth are not closed, this is an anomaly at the skeletal level. With this form of bite, the asymmetry of the face is usually expressed, the mismatching midline of the dentition, disproportionate to the face of the chin (protruding or underdeveloped)
ОIt is possible to stop the fixation of an incorrect bite only at the beginning of its development, that is, in childhood, during the period of primary bite and the change of baby teeth to permanent ones.
First of all, you need to pay attention to the following habits of the child:
If the jaws do not close properly - with a tip to one side, the child should be shown to the orthodontist. The doctor will choose(recommend) devices for bite correction, if necessary, grind primary canines to a natural level, and give recommendations for home exercises and work with habits.
Typically, in the early stages in children, crossbite is treated quickly and without braces. Provided that the child wears removable appliances and follows the recommendations
In the initial stages of crossbite development, complications are usually associated with the speed and complexity of treatment: the longer the bite is not corrected, the more difficult it will have to be treated in the future.
In the case of cross-occlusion of permanent teeth, teeth, gums and temporomandibular joint are subjected to constant uneven load. The risk of developing complications that require expensive treatment and the intervention of several specialists increases.
These symptoms appear individually and do not necessarily occur in full volume. However, any uneven load on the teeth increases the risk of tooth decay. With the correct bite, it is much easier to care for and maintain the health of the entire oral cavity.
Above, we indicated(mentioned) that the formation of a bite begins from childhood, so treatment in the early stages is much faster and easier.
The external manifestations of cross-occlusion can be determined visually, but the final diagnosis can be made only by an orthodontist. Therefore, if a child detects signs of improper closure, it is not recommended to self-medicate.
At the consultation, the doctor will conduct an examination, analyze the images(pictures) and draw up an individual treatment plan.
To achieve the result, the orthodontist can prescribe a set of measures, including wearing apparatus, and muscle training, and classes with a speech therapist.
In adults, crossbite is corrected in two ways, depending on the complexity of the pathology:
Surgical bite correction is used to correct the abnormal size of the jaws. As a rule, one surgical intervention is not enough: an orthognathic surgeon corrects only the size of the jaw and asymmetry, and the braces already move the teeth, correcting their closure and position..
If surgery is necessary, at first braces are installed to place the teeth in the correct position, and then surgery is done to correct the jaw. After the operation, the orthodontist details the dentition with the help of braces.
Orthodontic treatment with surgery is usually completed faster because the teeth do not need to move in the bone for a long time.
In cases where surgery is contraindicated, and braces cannot put the teeth in an ideal position, incomplete correction is performed. Such a patient is under the supervision of an orthodontist during the retention period in order to avoid relapse.
During orthodontic treatment, the patient may show signs of joint dysfunction due to changes in the position of the teeth during closure and changes in the load on the joint. Such patients are prescribed gymnastics or apparatus to relieve joint pain and exercise muscles. Timely measures to eliminate TMJ problems prevent serious complications from developing.
At the Konfidencia clinic, we provide patient comfort and a competent professional approach at all stages of treatment, including in the retention period after the removal of braces.
We pay considerable attention to the very first and most important stage of treatment - diagnosis.
To obtain high-quality CBCT images, we use a modern diagnostic 3D tomograph.
During diagnostics and at all stages of treatment, orthodontists conduct a photo protocol: all changes in the oral cavity are carefully recorded(written,documentated) and analyzed to track the dynamics of treatment and eliminate errors
Diagnostic cases are discussed at daily meetings of orthodontists to get the most complete picture of treatment with all the nuances.
Orthodontists are certified to work on a variety of braces and aligners. Our patients can choose the most convenient orthodontic apparatus for them:
The Konfidencia orthodontic team consists of 15 qualified orthodontists, three of whom are opinion leaders of Ormco Corporation, an American manufacturer of braces. Dentists-orthodontists Badmaeva Anna Nikolaevna and Petrova Elena Aleksandrovna are specialists in the treatment of the joint.
In difficult cases, during the preparation of a treatment plan other specialists of the clinic (orthopedists, surgeons, therapists) participate to create a step-by-step plan for the improvement of the entire oral cavity.
We cooperate with a proven orthognathic surgeon and osteopath, to whom we refer patients with indications to surgery or for more detailed work with the joint.
Автор: Petrova Elena Aleksandrovna, Dentist-orthodontist, специалист по лечению ВНЧС
Problem: smile aesthetics and defect in bite function.
Diagnosis: the treatment of upper and lower jaw teeth misalignment and class III malocclusion, caused by increased mandible growth, and prosthetic preparation.
Therapy method chosen: orthodontic treatment using stainless steel self-ligating brackets Damon Q without teeth extraction..
Treatment time: 3 years.
Problem: Smile Aesthetics
Diagnosis: treatment of severe crowding of the dentition.
Selected treatment method: orthodontic treatment with brackets without tooth extraction using the Damon Q metal self-ligating bracket system.
Treatment term: 2,5 years.