Early Intervention For Anterior Crossbite With Occlusal Trauma

Timely intervention is critical for anterior crossbite with occlusal interlocking in early mixed dentition. This case utilized a functional appliance system (posterior bite plate, double helix tongue spring, and labial bow) to achieve three therapeutic goals: correcting anterior crossbite, resolving occlusal trauma, and realigning the mandibular midline. After 7 months, normalized occlusion and canine/molar relationships were established, validating removable appliance efficacy in functional guidance. Patient: 7-year-old female with anterior crossbite and rightward mandibular midline deviation (∼1 central incisor width). Clinical findings included 1C-11/4C-31 crossbite, 21/31 occlusal trauma, severe gingival recession at tooth #31 (keratinized tissue <50% of adjacent tooth), and distal/mesial canine relationships. Treatment: Appliance: Maxillary bite plate with tongue spring + mandibular lingual arch + expansion mechanics. Objectives: Correct crossbite, eliminate trauma, restore midline. Outcome: Complete crossbite resolution and midline alignment at 7 months. Class I canine/molar relationships achieved. Persistent gingival attachment loss at #31 despite trauma resolution. Anterior crossbite with occlusal trauma in early mixed dentition requires urgent intervention. Unresolved dental interlocking can cause mandibular midline deviation and affect development. Multidisciplinary evaluation is needed due to persistent alveolar bone problems. Anterior crossbite in the mixed dentition stage not only harms periodontal health but also impacts facial harmony. Immediate intervention is necessary upon diagnosis. The indications and optimal timing for periodontal surgical intervention need further research.