Case Analysis Of Anterior Cross-Bite Correction

Objective: To analyze clinical diagnosis and treatment characteristics of two patients with anterior cross-bite and evaluate the effects of orthodontic treatment.Patients and methods: Patient A with anterior cross-bite was chosen from the patients with Class I malocclusion treated by Hospital of stomatology, Fujian Medical University in 2014. Patient A was a 20 years old female patient whose chief complaints were irregular upper dentition and anterior cross-bite. The sagittal skeletal relationship was Class III, maxillary retruded, the mandibular planes angle was average, and straight profile. She presented with Class I molar relationships on both side and lower midline shift to right 3mm. Model measurement revealed severe upper dentition crowding, slight lower dentition crowding. The curve of Spee was 3.5mm. The patient selected the camouflaged treatment. Four first premolars were extracted for orthodontic treatment. Straight Arch Wire Technique was used to align and level the dental arch, close extraction space, adjust occlusion and establish a correct overbite and overjet.Patient B with anterior cross-bite was a 18 years old female patient whose chief complaint was anterior cross-bite. She was diagnosed of skeletal class III malocclusion. The profile was concave with retrusive maxilla and mandibular protrusion. She presented with Class III buccal segment relationships on both side and both upper and lower arches' midline shift to left 1.5mm. Model measurement revealed moderate upper dentition crowding and slight lower dentition crowding. The curve of Spee was 1.5mm. Combined orthodontics and orthognathic surgery was used for the treatment. Two maxillary second premolars were extracted before surgery to relieve denture crowding, remove the compensatory, match the arch, and remove occlusal interference. Then, orthognathic therapy was carried out via Le Fort osteotomy, bilateral sagittal ?split ramus osteotomy, and genioplasty to move maxillary forward,rotate and set back mandibular. 4 weeks after orthognathic surgery, postoperative orthodontic therapy which including delicate adjustment of occlusion was carried out.Results: After treatment, two patients' anterior cross-bite were corrected, and acquired normal overbite, overjet, regular dentition, and good occlusion. Soft tissue of facial profile was improved obviously.Conclusion:The orthodontists should diagnose the malocclusion correctly and design the treatment protocols precisely. And serve the patients better by utilizing the objective criteria to determine the dentofacial changes in direction and distance.