Early Orthodontics Links Childhood Nighttime Bruxism Via Crown Elongation

Anterior crossbite and bruxism in children often coexist, impacting craniofacial development and sleep quality. Limited research exists on integrated treatments addressing both malocclusion and bruxism. This case highlights an innovative multidisciplinary strategy combining orthodontics, surgery, and airway management to resolve these issues, emphasizing the role of crown elongation and airway patency. A 5-year-old female presented with anterior crossbite, severe bruxism, snoring, and tonsillar hypertrophy. Clinical evaluation revealed skeletal Class III malocclusion, short maxillary anterior crowns, and airway obstruction. Treatment included adenotonsillectomy (ENT collaboration), maxillary expansion (spiral split plate), occlusal splint therapy (dual-curve tongue spring appliance, Manufacturer: Generic), and anterior crown lengthening (strip crowns with composite resin). Post-treatment cephalometric and panoramic analyses confirmed normalized overbite/overjet, resolved bruxism, improved facial symmetry, and stable occlusion over 2 years. The intervention’s success aligns with literature linking airway obstruction to bruxism . Maxillary expansion reduced muscle tension, while crown elongation optimized occlusal forces, preventing relapse . Adenotonsillectomy improved airway patency, corroborating Pereira et al. on surgical stabilization of orthodontic outcomes. The multidisciplinary approach ensured holistic management, addressing functional, aesthetic, and airway-related etiologies. This case demonstrates that early, multidisciplinary intervention—integrating orthodontics, surgery, and airway correction—effectively resolves childhood bruxism and malocclusion. Crown elongation and adenotonsillectomy were pivotal for occlusal stability and symptom relief. The strategy offers a clinically replicable model for managing complex pediatric cases, emphasizing collaboration between dental and ENT specialties to achieve long-term functional and aesthetic outcomes.