Removable plate treatment of anterior forced crossbite: Effectiveness, efficiency, and potential outcome predictors

In addition to studying the effectiveness and efficiency of removable acrylic plates in correcting anterior forced crossbite, the influence of outcome predictors were evaluated.

In all, 65 patients met the inclusion criteria of anterior forced crossbite, mixed dentition, removable plate treatment, and complete case documentation. Effectiveness was assessed based on pre- and posttreatment study casts (which were analyzed for successful treatment outcomes defined as ≥ 1 mm of overjet and overbite) and efficiency was assessed based on treatment duration and number of appointments. Potential outcome predictors were also evaluated, including age, gender, dental maturity, Angle Class, number of teeth in crossbite, severity of crossbite, overbite, ANB angle, Wits appraisal, mandibular plane angle, and patient compliance.

Successful crossbite correction was achieved in 48 of the 65 patients (74%) within a median of 2.8 months and 2.0 appointments. Plate treatment was discontinued following another median of 11.6 months and 6.5 appointments. Promising outcome predictors are the number of teeth in crossbite (1-2 versus 3-4 teeth = success in 81 versus 42% of cases), dental maturity (early versus late mixed dentition = success in 84 versus 52% of cases), and Angle Class (I versus III = success in 83 versus 61% of cases).

Removable acrylic plates were found to be moderately effective and efficient in correcting anterior forced crossbite. Children presenting with Angle Class I and crossbites involving not more than two teeth when treatment is started during the period of early mixed dentition had the best prognosis for treatment success.