Management of Early and Late Orthodontic Correction of Unilateral Crossbite- A Narrative Review


Authors : Dr. Sharath Kumar Shetty; Dr. Mahesh Kumar. Y; Dr. Sharanya. P.

Volume/Issue : Volume 10 - 2025, Issue 6 - June


Google Scholar : https://tinyurl.com/45rxc5fv

DOI : https://doi.org/10.38124/ijisrt/25jun126

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Crossbites are among the most frequently encountered malocclusions during the primary and mixed dentition stages, affecting approximately 5–8% of children between the ages of 3 and 12. In over 90% of these cases, a lateral mandibular shift occurs upon closure, resulting from a transverse discrepancy between the upper and lower dental arches. This mandibular rotation leads to the appearance of a unilateral posterior crossbite, typically involving multiple teeth in the buccal segments when the teeth are in centric occlusion. The underlying transverse discrepancy may stem from various contributing factors, such as narrowed maxillary inter canine width due to non-nutritive sucking habits, mouth breathing or airway obstruction, localized dental interferences, atypical tooth eruption patterns, or trauma. Given these risks, early correction of posterior crossbites is essential. Treatment should aim to guide developing teeth into more optimal functional positions and correct condylar asymmetry. Typically, this is achieved through maxillary expansion, which restores proper mandibular closure patterns and eliminates functional deviations. Performing these corrections during active growth phases facilitates favourable dentoskeletal changes, reduces long-term esthetic and functional complications, and simplifies treatment. Early intervention in primary or mixed dentition is generally less invasive, faster, and more physiologically manageable compared to treatments required at older ages.

Keywords : Unilateral Crossbite, Maxillary Transverse Deficiency, Mandibular Shift, Skeletal Discrepancy, Occlusal Imbalance.

References :

  1. Harrison, J.E. (2017). Early Management of Posterior Crossbites. In: Cobourne, M. (eds) Orthodontic Management of the Developing Dentition. Springer, Cham. https://doi.org/10.1007/978-3-319-54637-7_11.
  2. Steven D. Marshall, Karin A. Southard, Thomas E. Southard, Early Transverse Treatment, Seminars in Orthodontics, Volume 11, Issue 3, 2005, Pages 130-139, ISSN 1073-8746.
  3. Ronald A. Bell, Thomas J. Kiebach, Posterior crossbites in children: Developmental-based diagnosis and implications to normative growth patterns, Seminars in Orthodontics, Volume 20, Issue 2, 2014, Pages 77-113, ISSN 1073-8746.
  4. Ugolini, A., Doldo, T., Ghislanzoni, L.T.H. et al. Rapid palatal expansion effects on mandibular transverse dimensions in unilateral posterior crossbite patients: a three-dimensional digital imaging study. Prog Orthod. 17, 1 (2016). https://doi.org/10.1186/s40510-015-0114-9.
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  9. Alsawaf, D.H., Almaasarani, S.G., Hajeer, M.Y. et al. The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis. Prog Orthod. 23, 5 (2022). https://doi.org/10.1186/s40510-022-00398-4.
  10. Ilana Brin, Yocheved Ben-Bassat, Yoel Blustein, Jacob Ehrlich, Nira Hochman, Yitzhak Marmary, Avinoam Yaffe, Skeletal and functional effects of treatment for unilateral posterior crossbite, American Journal of Orthodontics and Dentofacial Orthopedics, Volume 109, Issue 2, 1996, Pages 173-179, ISSN 0889-5406.
  11. Aslihan Ertan , Elif Erbay, A comparison of different treatment techniques for posterior crossbite in the mixed dentition, American Journal of Orthodontics and Dentofacial Orthopedics, Volume 116, Issue 3, 1999, Pages 287-300, ISSN 0889-5406.

Crossbites are among the most frequently encountered malocclusions during the primary and mixed dentition stages, affecting approximately 5–8% of children between the ages of 3 and 12. In over 90% of these cases, a lateral mandibular shift occurs upon closure, resulting from a transverse discrepancy between the upper and lower dental arches. This mandibular rotation leads to the appearance of a unilateral posterior crossbite, typically involving multiple teeth in the buccal segments when the teeth are in centric occlusion. The underlying transverse discrepancy may stem from various contributing factors, such as narrowed maxillary inter canine width due to non-nutritive sucking habits, mouth breathing or airway obstruction, localized dental interferences, atypical tooth eruption patterns, or trauma. Given these risks, early correction of posterior crossbites is essential. Treatment should aim to guide developing teeth into more optimal functional positions and correct condylar asymmetry. Typically, this is achieved through maxillary expansion, which restores proper mandibular closure patterns and eliminates functional deviations. Performing these corrections during active growth phases facilitates favourable dentoskeletal changes, reduces long-term esthetic and functional complications, and simplifies treatment. Early intervention in primary or mixed dentition is generally less invasive, faster, and more physiologically manageable compared to treatments required at older ages.

Keywords : Unilateral Crossbite, Maxillary Transverse Deficiency, Mandibular Shift, Skeletal Discrepancy, Occlusal Imbalance.

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