Orthotown August 2018 - 20
message board
Unilateral Buccal Crossbite
Townie "clivestaples" shows a case with multiple options, including brackets, aligners and TADs
CliveStaples
Member Since: 10/13/14
Post: 1 of 13
Patient obviously has a full buccal crossbite on the left side with some extrusion. I'm planning
to use custom bite ramps on her max 1's, bond everything, then use crossbite elastics while actively
expanding the lower arch and constricting the upper with SS archwires. Seems pretty tough,
though. I wonder if I will end up intruding her anteriors before the posterior is out of crossbite.
One alternative is to use aligners that expand the lower and constrict the upper while using
crossbite elastics. This is a pain. I'd love to hear your thoughts on how to make this less painful! ■
3/27/2018
GreatLakesorthodontiscs
Member Since: 01/10/17
Post: 2 of 13
This is indeed a tough case!
I think I would place a palatal TAD-TPA in the palate, and powerchain from UL posteriors to
the bar anchored to TAD. This will help constrict UL posteriors and intrude them at the same time.
I would bond braces on the lower, add crossbite elastics and see how the bite ends up. If the
dental expansion in the lower is not sufficient, I may add an expanded lingual arch or other
appliances.
I am also interested in hearing how others would treat this case. ■
3/27/2018
splint123
Member Since: 03/03/06
Post: 3 of 13
Tough-your plan will probably work, but like you indicated, her posterior can collapse together
before the crossbite correcting. I've used posterior unilateral turbos "surfboards" that extend out
from the lingual of the uppers to guide her lower posterior teeth out of crossbite and keep her
bite separated while doing it. You can add contralateral standard buildups for bilateral support. ■
3/27/2018
Fenrisúlfr
Member Since: 02/25/09
Post: 4 of 13
20
I don't see a max cant due to overeruption of the L buccal segment, so I would consider a fi xed
anterior bite plate to disclude and then bond both arches. The lower left side seems very rolled
in and I'd use a .013 Damon archform to get the arch expanded ASAP. Once things are aligned
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