Application of an author-developed treatment approach for unilateral posterior crossbite with functional mandibular shift: a clinical case

Relevance. The prevalence of crossbite in children and adults across different populations ranges from 4% to 23%. During the primary and mixed dentition periods, unilateral posterior crossbite accompanied by a functional mandibular shift is most frequently observed. This condition may result in altered neuromuscular equilibrium and asymmetric mandibular growth. Conventional orthodontic management is primarily focused on maxillary expansion, whereas insufficient attention is often paid to correction of mandibular position. 
Case presentation. This article presents a clinical case of orthodontic treatment in a patient with unilateral posterior crossbite associated with a functional mandibular shift. The proposed author-developed treatment approach involves simultaneous maxillary expansion and mandibular repositioning, enabling functional correction at an early stage of occlusal development. 
Conclusion. Application of this orthodontic treatment method allows rapid establishment of normal occlusal relationships. The approach promotes symmetrical mandibular growth and contributes to the prevention of dentofacial asymmetry.

1. Thilander B, Bjerklin K. Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment? European Journal of Orthodontics. 2012;34(6):667–673. https://doi.org/10.1093/ejo/cjr095

2. Petrén S, Bjerklin K, Bondemark L. Stability of unilateral posterior crossbite correction in the mixed dentition: A randomized clinical trial with a 3-year follow-up. American Journal of Orthodontics and Dentofacial Orthopedics. 2011;139(1):e73-e81 https://doi.org/10.1016/j.ajodo.2010.06.018

3. Kennedy DB, Osepchook M. Unilateral posterior crossbite with mandibular shift: a review. Journal of the Canadian Dental Association. 2005;71(8):569-573. Available from: https://pubmed.ncbi.nlm.nih.gov/16202196

4. Agostino P, Ugolini A, Signori A, Silvestrini-Biavati A, Harrison JE, Riley P. Orthodontic treatment for posterior crossbites. Cochrane Database of Systematic Reviews. 2014:8. https://doi.org/10.1002/14651858.CD000979.pub2

5. Shishmareva A.S., Bimbas E.S., Khelashvili E.Z., Menshikova E.V., Plotnikov A.S., Shishmareva I.S., et al The prevalence of dentofacial abnormalities of children in the Sverdlovsk region. Actual Problems in Dentistry. 2023;19(1):110-120 (In Russ.). https://doi.org/10.18481/2077-7566-2023-19-1-110-120

6. Alsawaf DH, Almaasarani SG, Hajeer MY, Rajeh N. The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis. Progress in Orthodontics. 2022;23(1):5. https://doi.org/10.1186/s40510-022-00398-4.

7. Gizzatullina F.V., Mannanova F.F., Chudinova T.A. The incidence of cross-bite and its types in Ufa children and adolescents. Bashkortostan medical newsletter. 2014; 9(3):69-71 (In Russ.). Available from: https://elibrary.ru/sziedv

8. Lippold C, Stamm T, Meyer U, Végh A, Moiseenko T, Danesh G. Early treatment of posterior crossbite – a randomised clinical trial. Trials. 2013;14:20. https://doi.org/10.1186/1745-6215-14-20

9. Kecik D, Kocadereli I, Saatci I. Evaluation of the treatment changes of functional posterior crossbite in the mixed dentition. American journal of orthodontics and dentofacial orthopedics. 2007;131(2):202-215. https://doi.org/10.1016/j.ajodo.2005.03.030

10. Thilander B, Lennartsson B. 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. Journal of orofacial orthopedics. 2002;63(5):371-83. https://doi.org/10.1007/s00056-002-0210-6

11. Astashina N.B., Martyusheva M.V., Shchekolova N.B., Kadyrova E.V. Mechanisms of functional asymmetry of the face formation in patients with dysfunctional condition of temporomandibular joint. Perm Medical Journal. 2024;41(4):30-41 (In Russ.). https://doi.org/10.17816/pmj41430-41

12. Tamburrino RK, Boucher NS, Vanarsdall RL, Secchi A. The transverse dimension: Diagnosis and relevance to functional occlusion. Roth Williams International Society Orthodont Journal. 2010;2(1):13-22. Available from: https://studyres.com/doc/3638288/the-transverse-dimension--diagnosis-and?ysclid=mhaytqlu8a292862889