Korean J Orthod.  2014 May;44(3):143-153. 10.4041/kjod.2014.44.3.143.

Functional evaluation of orthopedic and orthodontic treatment in a patient with unilateral posterior crossbite and facial asymmetry

• Kwak YY
• Jang I
• Choi DS
• Cha BK

• KMID: 1975000
• DOI: http://doi.org/10.4041/kjod.2014.44.3.143

Abstract

An 8-years old boy with facial asymmetry and unilateral posterior crossbite on the left side received orthopedic and orthodontic treatment. During the first phase of treatment, the narrow maxillary arch was expanded using an acrylic plate. Then, the acrylic plate was used as a bite block with occlusal indentations from the construction bite that was obtained with the incisors in a coincident dental midline. After the position of the mandible was stabilized, the second phase of orthodontic treatment was initiated using fixed appliances for detailing of the occlusion. Skeletal symmetry, ideal occlusion, and coincident dental midlines were thus achieved. Functionally, occlusal force balance and masticatory muscle activity were improved, and the chewing patterns were normalized.

Keyword

Facial asymmetry; Chewing cycle; Electromyography; Maxillary expansion; Orthopedic treatment; Posterior crossbite

MeSH Terms

Bite Force
Electromyography
Facial Asymmetry*
Humans
Incisor
Male
Malocclusion*
Mandible
Mastication
Masticatory Muscles
Orthopedics*
Palatal Expansion Technique

Figure

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  Figure 1 Pretreatment photographs of facial symmetry of the patient at the age of 8 years and 6 months.

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  Figure 2 Pretreatment dental casts of the patient at the age of 8 years and 6 months.

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  Figure 3 Pretreatment cephalometric and panoramic radiographs obtained at the age of 8 years and 6 months.

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  Figure 4 Intraoral photograph of the unilateral posterior crossbite with an expansion plate.

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  Figure 5 Bite blocks of the expansion plate with occlusal indentations (A, arrow head) were adjusted using the construction bite, which was taken with the incisors in a coincident dental midline (B).

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  Figure 6 Intraoral photographs obtained 10 months after orthopedic treatment.

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  Figure 7 Intraoral photographs obtained after the first phase of treatment (patient age, 10 years and 6 months).

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  Figure 8 Facial and intraoral photographs obtained after the second phase of treatment (patient age, 13 years and 2 months).

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  Figure 9 Panoramic and cephalometric radiographs obtained after the second phase of treatment (patient age, 13 years and 2 months).

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  Figure 10 Superimposed cephalometric tracings at pretreatment (red, at 8 years and 6 months of age), after the first phase of treatment (green, at 10 years and 6 months of age), and after the second phase of treatment (blue, at 13 years and 2 months of age).

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  Figure 11 Tracings of submentovertex radiographs. A, Pretreatment (at 8 years and 6 months of age). B, After the second phase of treatment (at 13 years and 2 months of age).

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  Figure 12 T-scan recordings. A, Pretreatment (at 8 years and 6 months of age). B, After the second phase of treatment (at 13 years and 2 months of age).

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  Figure 13 Electromyographic recordings of the anterior temporal muscle and masseter muscle. A, Pretreatment (at 8 years and 6 months of age). B, After the second phase of treatment (at 13 years and 2 months of age).

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  Figure 14 Chewing cycle in the frontal view. The X- and Y-axes represent lateral and vertical movements, respectively. The red line indicates opening and the blue line indicates closing movements. A, Chewing cycles on the right and left side pretreatment. B, Chewing cycles on the right and left side after the second phase of treatment.

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