Orthodontic treatment for posterior crossbites

Area of Science:

• Orthodontics
• Pediatric Dentistry
• Craniofacial Development

Background:

• Posterior crossbite, where upper back teeth occlude inside lower back teeth, affects 4-17% of children and adolescents.
• This condition is linked to jaw development issues, joint problems, and facial asymmetry.
• Orthodontic appliances like quad-helix and expansion plates are used to expand the upper jaw and correct posterior crossbite.

Purpose of the Study:

• To evaluate the effectiveness of various orthodontic treatments for correcting posterior crossbites.
• To compare the outcomes of different appliances and interventions against observation and each other.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
• Thirty-one RCTs involving approximately 1410 participants were included.
• Data on posterior crossbite correction, inter-molar and inter-canine distances, and treatment duration were analyzed using fixed-effect models.

Main Results:

• For children (7-11 years), quad-helix and expansion plates significantly corrected posterior crossbites compared to observation, with high-certainty evidence.
• Quad-helix was more effective than expansion plates in correcting posterior crossbite and increasing inter-molar distance, with a shorter treatment duration.
• For adolescents (12-16 years), Hyrax and Haas appliances showed similar efficacy in correcting posterior crossbite and increasing inter-molar distance.

Conclusions:

• Quad-helix and expansion plates are beneficial for correcting posterior crossbites in children (7-11 years).
• Quad-helix demonstrates superior efficacy and shorter treatment duration compared to expansion plates in this age group.
• Evidence for adolescent treatment efficacy is less robust, with Hyrax and Haas showing comparable results.