Occlusion and Malocclusion - Class I Malocclusions

6 important questions on Occlusion and Malocclusion - Class I Malocclusions

Skeletal features of Class I malocclusion?

  • Usually skeletal Class I
  • May be mild Class II or Class III with dentoalveolar compensation
  • Vertical and transverse anomalies may be found e.g. AOB, crossbites 

Dental features of Class I malocclusion?

  • Most common problem is crowding, usually due to local factors
  • Spacing
  • Bimaxillary proclination
  • Vertical anomalies, e.g. AOB
  • Transverse anomalies, e.g. Crossbites, scissorbites   

Facial growth in Class I malocclusions?

Usually favourable but AOBs tend to worsen as dentoalveolar compensation is already at its limits
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Principles of managing a crossbite. (ref)

Managed by maxillary expansion but before planning treatment consider if there is a displacement (favourable) or a true asymmetry e.g. Skeletal (unfavourable) and manage appropriately

Gill et al., 2004 (Dental Update)

Treatment options for crossbite? (refs)

  • URA with midline screw/coffin spring
  • Quadhelix
  • RME
  • AW expansion in fixed appliances
  • Expansion arch (attached in molar tubes)
  • Surgical assisted expansion

Agostino et al., 2014 (Cochrane)
McNally et al., 2005 (RCT Quad vs Expansion Arch)

What is a lingual crossbite (scissorbite)? Management principle?

Buccal cusps of lower teeth occlude palatal to palatal cusps of upper teeth.

Needs mandibular expansion and maxillary contraction
If severe may need surgery

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