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Orthodontic treatment for posterior crossbites.
1Department of Clinical Dental Sciences, Liverpool University Dental Hospital, Pembroke Place, Liverpool, Merseyside, UK, L3 5PS. Jayne.Harrison@rlbuh-tr.nwest.nhs.uk
The Cochrane Database of Systematic Reviews
|May 2, 2001
Summary
Early dental intervention, such as occlusal grinding and removable expansion plates, can prevent posterior crossbites from persisting into permanent dentition. Further research is needed to compare various orthodontic treatments for maxillary expansion and crossbite correction.
Area of Science:
- Dentistry
- Orthodontics
- Craniofacial Development
Background:
- Posterior crossbite, where upper back teeth fit inside lower ones, can cause jaw deviation.
- The causes and developmental timing of posterior crossbites remain unclear.
- Various orthodontic treatments aim to widen the upper arch or address underlying causes like habits.
Purpose of the Study:
- To evaluate orthodontic treatments for maxillary expansion and posterior crossbite correction.
- To synthesize evidence from randomized and controlled clinical trials on posterior crossbite treatments.
Main Methods:
- Systematic review of randomized and controlled clinical trials (RCTs and CCTs) published between 1970-1999.
- Searches included Cochrane, MEDLINE, and key orthodontic journals.
- Data extraction focused on crossbite correction, dental expansion, and temporomandibular joint or respiratory outcomes.
Main Results:
- Occlusal grinding in primary dentition, with or without expansion plates, effectively prevented posterior crossbite perpetuation.
- No significant differences in molar/canine expansion were found between various rapid and slow maxillary expansion techniques or appliance types (banded vs. bonded, 2-point vs. 4-point).
- Insufficient data precluded formal analysis for some comparisons, such as two-point versus four-point rapid maxillary expansion.
Conclusions:
- Early intervention with occlusal grinding and expansion plates is effective in preventing the persistence of posterior crossbites.
- Current evidence is insufficient to recommend specific orthodontic treatments for maxillary expansion due to inconclusive comparative trial results.
- Further high-quality comparative trials are needed to guide clinical practice for posterior crossbite management.