CASE REPORT Before Treatment After Treatment Better Facial Sy Treating Crossbites With A Shift By Ron Austin, DDS I n the debate over early dental treatment, the liter-ature is in agreement over treating crossbites with a shift. Whether the crossbite is anterior or poste-rior, it needs to be treated as soon as possible. When the crossbite is causing a shift of the mandible, the malocclusion correction becomes more urgent in growing children. The following is a case report on my middle granddaughter who, at the time, was 4-years-old. Katy presented with a crossbite of the right side of her primary teeth. The problem mainly was an inter-ference of tooth C with tooth R. The interference caused the mandible to shift to the right approxi-mately 3mm. This is confirmed by the midline (Figs.1 & 2). 12 November/December 2010 JAOS The first choice of treatment was to equilibrate the primary canines, but the amount of enamel removal would have been too extensive. A remov-able appliance was considered but quickly rejected due to age and cooperation concerns. I prefer a fixed non-compliant approach when possible. The treatment consisted of banding A and J along with brackets on C through H. I then placed a .016 stainless arch wire with stops mesial to the molar tubes. A bead purchased at the local hobby store was then place between the molar band and the stop. This placed the arch wire 1mm out of the anterior incisor brackets (Fig. 3). All brackets were ligature tied tightly to the arch wire with the exception of tooth C, which was secured with an elastic tie only.
Journal of the American Orthodontic Society November-December 2010: Page 12
