Intervention Of Anterior Crossbite With Concomitant Unilateral Posterior Locked Occlusion

Pediatric anterior crossbite with unilateral posterior locked occlusion not only impairs chewing function and increases risk of TMJ disorders, but may also disrupt craniofacial development. For children with compliance challenges, our clinic employs a modified nighttime silicone appliance with targeted force application, combined with tongue posture training, achieving effective malocclusion correction through minimally invasive intervention. A 4-year-old child presented with anterior crossbite and unilateral chewing difficulty. Clinical examination revealed anterior crossbite, left posterior locked occlusion (maxillary arch overexpansion), and infantile swallowing pattern. Given limited daytime compliance, treatment involved nighttime wear of a modified silicone appliance combined with tongue posture/swallowing training, supplemented by palatal resin build-up for targeted force application. Monthly evaluations showed progressive improvement: chewing efficiency significantly improved at 5 months with resolved anterior crossbite and partial posterior correction. A 3D-optimized appliance was then fabricated for continued treatment, achieving full posterior occlusion correction after 2 additional months. Follow-up includes 3-month nighttime retention and ongoing myofunctional exercises with quarterly monitoring. For the correction of anterior crossbite with unilateral posterior locked occlusion, adopting a simplified nighttime-only protocol that prioritizes comfort and compliance significantly enhances treatment acceptance in pediatric patients, effectively reducing dental phobia incidence while achieving therapeutic goals. Nighttime use of a modified silicone appliance with biomechanically optimized force application, combined with sustained myofunctional re-education, effectively corrects anterior crossbite with unilateral posterior locked occlusion. This protocol offers a patient-friendly solution for children with compliance challenges or those prioritizing treatment comfort.