A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition--occlusal and skeletal characteristics of significance in predicting the long-term outcome

Abstract

Background and aim: The generally recommended treatment in children with unilateral posterior crossbite is expansion of the maxillary dental arch. The reported treatment success rate varies between 50% and 96%. The aim of the present study was to analyse whether some occlusal and skeletal characteristics could be found in the deciduous dentition of children with treatment success (including self-correction) in contrast to those showing non-correction (including relapse) in the young permanent dentition.

Patients and method: Two groups of children with unilateral posterior crossbite were followed from the age of 5 years up to 13 years of age. The children in one of the groups (n = 32) were treated in the deciduous dentition, while the children in the other group (n = 32) were to be treated in the late mixed or early permanent dentition. Another 25 children (5 years old) with excellent occlusion were included as controls. Results of clinical examination and biometric and cephalometric analyses, performed at the first examination (at 5 years of age), are presented for the three groups ("treated" "untreated" and controls).

Results and conclusions: Compared to the controls, asymmetry was registered in both dental arches. The crossbite side, measured to the midline, was narrower than the non-crossbite side in the upper jaw but broader in the lower jaw. Differences between upper/lower widths (at intercanine and intermolar level) seem to be of importance for correction or non-correction, both for "untreated" and "treated" children. A narrow crossbite side in the upper arch together with a broad crossbite side in the lower arch was found in non-corrected children in both groups, even among those treated with maxillary expansion, where the SNB angle was larger and the ANB angle smaller than in controls as well as in those with correction (including self-correction). Possibilities and limitations of treatment planning are discussed.