Introduction to Orthodontic Imaging Methods

Introduction to Orthodontic Imaging Methods

Brief overview of orthodontic treatment for kids and the importance of imaging methods in diagnosis and treatment planning

Orthodontic treatment for kids is a specialized field aimed at correcting dental and jaw irregularities to ensure proper growth and development of the teeth and face. This treatment often begins in childhood because early intervention can prevent more severe problems later in life. Common issues addressed include misaligned teeth, overcrowding, gaps between teeth, and jaw discrepancies. The primary goal is to create a healthy, functional, and aesthetically pleasing smile.


Imaging methods play a crucial role in the diagnosis and treatment planning of orthodontic cases. Early orthodontic evaluations are recommended around age seven Early orthodontic intervention dental caries. These methods provide detailed insights into the structure and positioning of teeth and jaws, which are essential for developing an effective treatment plan. Here are some key imaging techniques used in orthodontics:




  1. Panoramic X-rays: These provide a broad view of the entire mouth, including all the teeth, jawbones, and sinuses. They are useful for identifying impacted teeth, assessing jaw growth, and detecting any abnormalities.




  2. Cephalometric X-rays: These are profile X-rays that help orthodontists evaluate the relationship between the teeth, jawbones, and skull. They are crucial for diagnosing skeletal discrepancies and planning treatments that involve growth modification.




  3. Intraoral Photographs: High-quality photos of the teeth and mouth provide a clear visual record of the current state of the teeth and help in monitoring progress throughout treatment.




  4. 3D Imaging: Advanced technologies like Cone Beam Computed Tomography (CBCT) offer detailed, three-dimensional images of the teeth and jaw structures. This is particularly useful for complex cases where a thorough understanding of the spatial relationships is necessary.




  5. Study Models: Impressions of the teeth are used to create physical models that allow orthodontists to analyze bite relationships and plan treatments more precisely.




In conclusion, orthodontic treatment for kids is vital for ensuring proper dental development, and imaging methods are indispensable tools in this process. They provide the necessary information to diagnose issues accurately and plan effective treatments, ultimately leading to better outcomes for young patients.

Explanation of the various orthodontic imaging methods commonly used, such as panoramic radiographs, cephalometric radiographs, and cone-beam computed tomography (CBCT) —

Certainly! Orthodontic imaging methods are essential tools in assessing, diagnosing, and planning dental and orthodontic treatments. Let's delve into some of the most commonly used methods: panoramic radiographs, cephalometric radiographs, and cone-beam computed tomography (CBCT).


Panoramic radiographs, often known as panorex or orthopantomograms, provide a broad overview of the entire mouth in a single image. This imaging technique captures both the upper and lower jaws, showing all the teeth, jawbones, sinuses, and the temporomandibular joints (TMJ). It's particularly useful for identifying impacted teeth, evaluating jaw growth and development, and detecting pathologies such as cysts or tumors. However, it's worth noting that panoramic radiographs have limitations in terms of detail and can sometimes distort the image, making precise measurements challenging.


Cephalometric radiographs, or cephs, are specialized X-rays that provide a side view of the skull. They are primarily used to assess the relationship between the teeth, jaws, and facial skeleton. By analyzing these radiographs, orthodontists can evaluate facial proportions, jaw growth patterns, and the position of teeth relative to the jaws. Cephalometric analysis helps in diagnosing skeletal discrepancies, planning orthodontic treatment, and monitoring treatment progress over time. However, like panoramic radiographs, cephalometric images offer limited three-dimensional information and may not provide a complete picture of complex dental issues.


Cone-beam computed tomography (CBCT) represents a significant advancement in orthodontic imaging technology. Unlike traditional X-rays, CBCT produces detailed, three-dimensional images of the teeth, jaws, and surrounding structures. This imaging modality allows orthodontists to visualize the patient's anatomy from multiple angles and planes, providing a more comprehensive assessment of complex dental and skeletal issues. CBCT is particularly valuable in cases involving impacted teeth, jaw abnormalities, and surgical planning for orthodontic treatment. However, it's essential to consider the increased radiation exposure associated with CBCT scans compared to traditional X-rays.


In conclusion, orthodontic imaging methods play a crucial role in modern dental and orthodontic practice. Panoramic radiographs, cephalometric radiographs, and cone-beam computed tomography each offer unique advantages in diagnosing and planning treatment for various dental and skeletal issues. By utilizing these imaging techniques effectively, orthodontists can provide more accurate diagnoses, develop tailored treatment plans, and ultimately achieve better outcomes for their patients.

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 Choosing the right orthodontic appliance for your dental needs

When it comes to orthodontic treatment, choosing the right appliance is just the beginning.. Proper maintenance and care are crucial to ensure the effectiveness of your treatment and to maintain your oral health.

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The latest diagnostic tools improving orthodontic treatment

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In the ever-evolving field of orthodontics, future trends and potential advancements in diagnostic technology hold the promise of revolutionizing treatment methods and patient outcomes.. As technology continues to advance at a rapid pace, the diagnostic tools available to orthodontists are becoming increasingly sophisticated, allowing for more precise and personalized treatment plans. One of the most exciting future trends in orthodontic diagnostic technology is the integration of artificial intelligence (AI) and machine learning algorithms.

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Description of the benefits and limitations of each imaging method, including factors such as radiation exposure, image quality, and cost

Orthodontic imaging methods play a crucial role in diagnosing and treating dental and skeletal issues. Each method offers unique benefits and limitations, making it essential to understand their distinctions to optimize patient care.


Firstly, panoramic radiographs are widely used due to their ability to capture a broad view of the upper and lower jaws in a single image. This method is beneficial for assessing tooth development, detecting pathologies, and planning orthodontic treatments. However, panoramic radiographs have limitations in providing detailed images of specific areas and may expose patients to a moderate level of radiation.


Cone Beam Computed Tomography (CBCT) offers a more detailed three-dimensional view of the craniofacial structures. This method is particularly advantageous for complex cases requiring precise assessments of tooth roots, bone density, and jaw alignment. CBCT scans provide superior image quality compared to traditional radiographs, aiding in accurate diagnosis and treatment planning. Nevertheless, CBCT involves higher radiation exposure and is more costly, which may be a consideration for routine use.


Cephalometric radiographs are another essential tool in orthodontics, providing lateral views of the skull to analyze facial growth patterns and jaw relationships. These images are invaluable for treatment planning and monitoring progress. While cephalometric radiographs offer detailed information, they expose patients to radiation and may not capture all necessary details in three dimensions.


Intraoral photographs complement radiographic images by providing visual documentation of the teeth and soft tissues. They are non-invasive, cost-effective, and essential for monitoring changes over time. However, they lack the diagnostic depth offered by radiographic methods.


Lastly, study models, created from impressions of the teeth, offer a tangible representation of the dental arches. They are useful for analyzing occlusion, tooth alignment, and planning orthodontic appliances. While study models provide valuable insights, they require physical storage space and may not capture soft tissue details.


In conclusion, each orthodontic imaging method has its benefits and limitations. Clinicians must weigh factors such as radiation exposure, image quality, and cost to select the most appropriate method for each patient's needs. By understanding these distinctions, orthodontists can enhance diagnostic accuracy and deliver optimal treatment outcomes.

Description of the benefits and limitations of each imaging method, including factors such as radiation exposure, image quality, and cost

Discussion of the role of digital imaging technologies in modern orthodontics, including the use of 3D imaging and computer-aided design and manufacturing (CAD/CAM) systems

In the ever-evolving field of orthodontics, digital imaging technologies have revolutionized the way practitioners diagnose, plan, and execute treatments. The integration of 3D imaging and CAD/CAM systems has significantly enhanced the precision, efficiency, and overall patient experience in modern orthodontic practice.


Traditionally, orthodontic assessments relied heavily on 2D radiographs and plaster models, which often provided limited perspectives and required considerable manual labor for diagnosis and treatment planning. The advent of digital imaging technologies has transcended these limitations, offering a comprehensive, three-dimensional view of the patient's dental and skeletal structures.


3D imaging, particularly Cone Beam Computed Tomography (CBCT), has become a cornerstone in orthodontic diagnostics. CBCT scans provide detailed, high-resolution images that allow orthodontists to visualize the entire craniofacial complex. This level of detail is crucial for identifying complex malocclusions, assessing root positions, and planning surgical interventions with greater accuracy. Moreover, 3D imaging facilitates better communication with patients, as it enables practitioners to illustrate treatment plans and expected outcomes more effectively.


Complementing 3D imaging is the use of CAD/CAM systems in orthodontics. These systems allow for the digital design and fabrication of orthodontic appliances, such as brackets, aligners, and retainers. CAD/CAM technology ensures a higher degree of customization and precision, as each appliance can be tailored to the unique anatomy of the patient's dentition. This not only improves the fit and comfort of the appliances but also enhances the efficiency of tooth movement during treatment.




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The integration of digital imaging and CAD/CAM in orthodontics also streamlines the workflow. Digital impressions eliminate the need for messy traditional molds, reducing chair time and improving patient comfort. Furthermore, the ability to simulate treatment outcomes using software allows orthodontists to predict and refine treatment plans before any physical intervention occurs.


In conclusion, the role of digital imaging technologies in modern orthodontics cannot be overstated. The use of 3D imaging and CAD/CAM systems has transformed the field, offering unprecedented levels of accuracy, efficiency, and patient satisfaction. As these technologies continue to advance, they promise to further elevate the standards of orthodontic care, making treatments more effective and patient-friendly.

Overview of the importance of proper image interpretation and analysis in orthodontic treatment planning, including the use of landmarks, measurements, and tracings

In the realm of orthodontics, the significance of proper image interpretation and analysis cannot be overstated. This critical aspect of treatment planning lays the groundwork for successful orthodontic interventions, ensuring that each patient receives a tailored approach that addresses their unique dental and facial characteristics. The process involves a meticulous examination of various imaging modalities, including cephalometric radiographs, panoramic radiographs, and cone-beam computed tomography (CBCT) scans, among others.


At the heart of image interpretation in orthodontics is the identification and use of anatomical landmarks. These landmarks serve as reference points for measuring and analyzing the spatial relationships between different structures within the craniofacial complex. By accurately locating these landmarks, orthodontists can assess the position of teeth, the alignment of jaws, and the overall symmetry of the face. This foundational step is crucial for diagnosing malocclusions, planning orthodontic movements, and predicting treatment outcomes.


Measurements derived from these landmarks are equally vital. They provide quantitative data that help orthodontists evaluate the severity of dental discrepancies, plan the mechanics of tooth movement, and monitor progress throughout treatment. Common measurements include angles, distances, and ratios that reflect the skeletal and dental relationships. For instance, the ANB angle, which measures the anteroposterior relationship between the maxilla and mandible, is a key indicator of skeletal class and can influence treatment strategy.


Tracings, or the process of outlining the anatomical structures on radiographs, further enhance the analysis by allowing for a visual representation of the patient's craniofacial morphology. This technique enables orthodontists to superimpose different radiographs taken at various stages of treatment, facilitating a direct comparison and assessment of changes over time.

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Tracings also aid in the construction of treatment plans by providing a clear visualization of the proposed tooth movements and their expected impact on facial aesthetics and function.


In conclusion, the proper interpretation and analysis of orthodontic images, through the use of landmarks, measurements, and tracings, is indispensable in treatment planning. It ensures that each patient's unique needs are addressed with precision and care, ultimately leading to more effective and aesthetically pleasing outcomes. As technology advances, the integration of digital imaging and software analysis promises to further refine these processes, enhancing the accuracy and efficiency of orthodontic care.

Explanation of the role of orthodontic imaging in monitoring treatment progress and evaluating treatment outcomes

Orthodontic imaging plays a crucial role in both monitoring the progress of orthodontic treatment and evaluating its outcomes. This is because it provides orthodontists with visual data that is essential for making informed decisions throughout the treatment process. Here's how orthodontic imaging contributes to these aspects:


Firstly, in monitoring treatment progress, orthodontic images such as X-rays, photographs, and scans allow orthodontists to track the movement of teeth and jaw alignment over time. These images help in assessing whether the teeth are shifting as planned and if the bite is improving. For instance, periodic panoramic X-rays can show the position of teeth roots and the jawbone, which is vital for ensuring that the treatment is on the right track and making necessary adjustments if deviations are noted.


Secondly, evaluating treatment outcomes is another critical area where orthodontic imaging is indispensable. After the active phase of treatment, images are taken to compare the final results with the initial conditions. This comparison helps in determining the effectiveness of the treatment and whether the goals, such as proper alignment and a healthy bite, have been achieved. Moreover, it aids in identifying any residual issues that might need further attention or retention strategies to maintain the achieved alignment.


In summary, orthodontic imaging is not just a tool for diagnosis but also a vital component in the ongoing management and assessment of orthodontic treatment. It ensures that the treatment is effective and that the patient achieves the desired outcomes, ultimately contributing to their overall oral health and confidence.



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Discussion of the ethical considerations associated with the use of orthodontic imaging, including informed consent, radiation safety, and patient confidentiality

Introduction to Orthodontic Imaging Methods brings with it a series of ethical considerations that must be carefully navigated to ensure the well-being and trust of patients. At the heart of these considerations lie three pivotal elements: informed consent, radiation safety, and patient confidentiality.


Informed consent is the cornerstone of ethical practice in orthodontic imaging. It entails a comprehensive dialogue between the orthodontist and the patient or their guardians, especially in the case of minors. This conversation should elucidate the purpose of the imaging, the type of images to be taken, and the potential benefits and risks associated with the procedure. It is crucial that this information is communicated in an accessible manner, ensuring that patients are not only aware of what the process entails but also feel empowered to ask questions and express concerns. This fosters a collaborative environment where patients are active participants in their own care.


Radiation safety is another critical aspect that demands meticulous attention. While orthodontic imaging, such as X-rays and cone-beam computed tomography (CBCT), is invaluable for diagnosis and treatment planning, it is not without risks. Exposure to radiation, even at low doses, can pose long-term health risks. Therefore, orthodontists must adhere to the principle of ALARA (As Low As Reasonably Achievable), ensuring that the radiation dose is minimized without compromising the diagnostic quality of the images. This involves using the latest technology that offers lower radiation exposure, regularly reviewing and updating imaging protocols, and only prescribing imaging when it is clinically justified.


Patient confidentiality is the third pillar of ethical considerations in orthodontic imaging. The images and records obtained are sensitive information that must be protected with the utmost care. Orthodontists have a duty to safeguard this information from unauthorized access or disclosure. This includes secure storage of both physical and digital records, ensuring that access to patient information is restricted to authorized personnel only, and obtaining explicit consent from patients before sharing their images for educational or research purposes.


In conclusion, the ethical landscape of orthodontic imaging is complex, requiring a delicate balance between advancing patient care and protecting patient rights. By prioritizing informed consent, ensuring radiation safety, and maintaining patient confidentiality, orthodontists can navigate this landscape with integrity, fostering trust and enhancing the quality of care provided.

Orthodontic imaging methods have significantly evolved over the years, providing more precise and efficient ways to assess, diagnose, and treat dental and facial irregularities in children. This essay summarizes the key takeaways and outlines future directions for research and innovation in this field.


Firstly, the use of digital imaging techniques, such as cone-beam computed tomography (CBCT) and digital cephalometric radiography, has revolutionized orthodontic diagnostics. These methods offer detailed, three-dimensional views of the craniofacial structures, allowing orthodontists to make more informed decisions regarding treatment plans. Additionally, the integration of software tools for image analysis has enhanced the accuracy of measurements and predictions, leading to better treatment outcomes.


Secondly, the development of more child-friendly imaging technologies is crucial. Children often experience anxiety and discomfort during imaging procedures. Innovations such as reduced-radiation protocols and the use of virtual reality to distract patients during scans are promising approaches to mitigate these issues. Ensuring that imaging procedures are as comfortable and stress-free as possible for young patients is essential for their cooperation and the overall success of their orthodontic treatment.


Furthermore, the incorporation of artificial intelligence (AI) and machine learning into orthodontic imaging is a burgeoning area of research. These technologies have the potential to automate the analysis of images, identify patterns, and predict treatment outcomes with greater precision. AI-driven tools could assist orthodontists in making more accurate diagnoses and developing personalized treatment plans tailored to each child's unique needs.


Looking ahead, future research should focus on enhancing the safety and efficacy of orthodontic imaging methods. This includes exploring lower-radiation alternatives and improving the resolution and clarity of images. Additionally, longitudinal studies are needed to assess the long-term outcomes of treatments planned using advanced imaging techniques. Understanding the impact of these innovations on patient satisfaction and treatment success will be vital for continued progress in the field.


In conclusion, the advancements in orthodontic imaging methods for children have greatly improved diagnostic accuracy and treatment planning. Future directions for research should aim to make these technologies more child-friendly, integrate AI for enhanced analysis, and ensure the long-term safety and efficacy of these methods. Continued innovation in this area will undoubtedly lead to better orthodontic care for young patients.

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Crossbite
Unilateral posterior crossbite
Specialty Orthodontics

In dentistry, crossbite is a form of malocclusion where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either closer to the cheek or to the tongue) than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral misalignment of the dental arches.[1][2]

Anterior crossbite

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Class 1 with anterior crossbite

An anterior crossbite can be referred as negative overjet, and is typical of class III skeletal relations (prognathism).

Primary/mixed dentitions

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An anterior crossbite in a child with baby teeth or mixed dentition may happen due to either dental misalignment or skeletal misalignment. Dental causes may be due to displacement of one or two teeth, where skeletal causes involve either mandibular hyperplasia, maxillary hypoplasia or combination of both.

Dental crossbite

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An anterior crossbite due to dental component involves displacement of either maxillary central or lateral incisors lingual to their original erupting positions. This may happen due to delayed eruption of the primary teeth leading to permanent teeth moving lingual to their primary predecessors. This will lead to anterior crossbite where upon biting, upper teeth are behind the lower front teeth and may involve few or all frontal incisors. In this type of crossbite, the maxillary and mandibular proportions are normal to each other and to the cranial base. Another reason that may lead to a dental crossbite is crowding in the maxillary arch. Permanent teeth will tend to erupt lingual to the primary teeth in presence of crowding. Side-effects caused by dental crossbite can be increased recession on the buccal of lower incisors and higher chance of inflammation in the same area. Another term for an anterior crossbite due to dental interferences is Pseudo Class III Crossbite or Malocclusion.

Single tooth crossbite

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Single tooth crossbites can occur due to uneruption of a primary teeth in a timely manner which causes permanent tooth to erupt in a different eruption pattern which is lingual to the primary tooth.[3] Single tooth crossbites are often fixed by using a finger-spring based appliances.[4][5] This type of spring can be attached to a removable appliance which is used by patient every day to correct the tooth position.

Skeletal crossbite

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An anterior crossbite due to skeletal reasons will involve a deficient maxilla and a more hyperplastic or overgrown mandible. People with this type of crossbite will have dental compensation which involves proclined maxillary incisors and retroclined mandibular incisors. A proper diagnosis can be made by having a person bite into their centric relation will show mandibular incisors ahead of the maxillary incisors, which will show the skeletal discrepancy between the two jaws.[6]

Posterior crossbite

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Bjork defined posterior crossbite as a malocclusion where the buccal cusps of canine, premolar and molar of upper teeth occlude lingually to the buccal cusps of canine, premolar and molar of lower teeth.[7] Posterior crossbite is often correlated to a narrow maxilla and upper dental arch. A posterior crossbite can be unilateral, bilateral, single-tooth or entire segment crossbite. Posterior crossbite has been reported to occur between 7–23% of the population.[8][9] The most common type of posterior crossbite to occur is the unilateral crossbite which occurs in 80% to 97% of the posterior crossbite cases.[10][3] Posterior crossbites also occur most commonly in primary and mixed dentition. This type of crossbite usually presents with a functional shift of the mandible towards the side of the crossbite. Posterior crossbite can occur due to either skeletal, dental or functional abnormalities. One of the common reasons for development of posterior crossbite is the size difference between maxilla and mandible, where maxilla is smaller than mandible.[11] Posterior crossbite can result due to

  • Upper Airway Obstruction where people with "adenoid faces" who have trouble breathing through their nose. They have an open bite malocclusion and present with development of posterior crossbite.[12]
  • Prolong digit or suckling habits which can lead to constriction of maxilla posteriorly[13]
  • Prolong pacifier use (beyond age 4)[13]

Connections with TMD

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Unilateral posterior crossbite

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Unilateral crossbite involves one side of the arch. The most common cause of unilateral crossbite is a narrow maxillary dental arch. This can happen due to habits such as digit sucking, prolonged use of pacifier or upper airway obstruction. Due to the discrepancy between the maxillary and mandibular arch, neuromuscular guidance of the mandible causes mandible to shift towards the side of the crossbite.[14] This is also known as Functional mandibular shift. This shift can become structural if left untreated for a long time during growth, leading to skeletal asymmetries. Unilateral crossbites can present with following features in a child

  • Lower midline deviation[15] to the crossbite side
  • Class 2 Subdivision relationships
  • Temporomandibular disorders [16]

Treatment

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A child with posterior crossbite should be treated immediately if the child shifts their mandible on closing, which is often seen in a unilateral crossbite as mentioned above. The best age to treat a child with crossbite is in their mixed dentition when their palatal sutures have not fused to each other. Palatal expansion allows more space in an arch to relieve crowding and correct posterior crossbite. The correction can include any type of palatal expanders that will expand the palate which resolves the narrow constriction of the maxilla.[9] There are several therapies that can be used to correct a posterior crossbite: braces, 'Z' spring or cantilever spring, quad helix, removable plates, clear aligner therapy, or a Delaire mask. The correct therapy should be decided by the orthodontist depending on the type and severity of the crossbite.

One of the keys in diagnosing the anterior crossbite due to skeletal vs dental causes is diagnosing a CR-CO shift in a patient. An adolescent presenting with anterior crossbite may be positioning their mandible forward into centric occlusion (CO) due to the dental interferences. Thus finding their occlusion in centric relation (CR) is key in diagnosis. For anterior crossbite, if their CO matches their CR then the patient truly has a skeletal component to their crossbite. If the CR shows a less severe class 3 malocclusion or teeth not in anterior crossbite, this may mean that their anterior crossbite results due to dental interferences.[17]

Goal to treat unilateral crossbites should definitely include removal of occlusal interferences and elimination of the functional shift. Treating posterior crossbites early may help prevent the occurrence of Temporomandibular joint pathology.[18]

Unilateral crossbites can also be diagnosed and treated properly by using a Deprogramming splint. This splint has flat occlusal surface which causes the muscles to deprogram themselves and establish new sensory engrams. When the splint is removed, a proper centric relation bite can be diagnosed from the bite.[19]

Self-correction

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Literature states that very few crossbites tend to self-correct which often justify the treatment approach of correcting these bites as early as possible.[9] Only 0–9% of crossbites self-correct. Lindner et al. reported that 50% of crossbites were corrected in 76 four-year-old children.[20]

See also

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  • List of palatal expanders
  • Palatal expansion
  • Malocclusion

References

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  1. ^ "Elsevier: Proffit: Contemporary Orthodontics · Welcome". www.contemporaryorthodontics.com. Retrieved 2016-12-11.
  2. ^ Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour F (October 2009). "Malocclusion and occlusal traits in an urban Iranian population. An epidemiological study of 11- to 14-year-old children". European Journal of Orthodontics. 31 (5): 477–84. doi:10.1093/ejo/cjp031. PMID 19477970.
  3. ^ a b Kutin, George; Hawes, Roland R. (1969-11-01). "Posterior cross-bites in the deciduous and mixed dentitions". American Journal of Orthodontics. 56 (5): 491–504. doi:10.1016/0002-9416(69)90210-3. PMID 5261162.
  4. ^ Zietsman, S. T.; Visagé, W.; Coetzee, W. J. (2000-11-01). "Palatal finger springs in removable orthodontic appliances--an in vitro study". South African Dental Journal. 55 (11): 621–627. ISSN 1029-4864. PMID 12608226.
  5. ^ Ulusoy, Ayca Tuba; Bodrumlu, Ebru Hazar (2013-01-01). "Management of anterior dental crossbite with removable appliances". Contemporary Clinical Dentistry. 4 (2): 223–226. doi:10.4103/0976-237X.114855. ISSN 0976-237X. PMC 3757887. PMID 24015014.
  6. ^ Al-Hummayani, Fadia M. (2017-03-05). "Pseudo Class III malocclusion". Saudi Medical Journal. 37 (4): 450–456. doi:10.15537/smj.2016.4.13685. ISSN 0379-5284. PMC 4852025. PMID 27052290.
  7. ^ Bjoerk, A.; Krebs, A.; Solow, B. (1964-02-01). "A Method for Epidemiological Registration of Malocculusion". Acta Odontologica Scandinavica. 22: 27–41. doi:10.3109/00016356408993963. ISSN 0001-6357. PMID 14158468.
  8. ^ Moyers, Robert E. (1988-01-01). Handbook of orthodontics. Year Book Medical Publishers. ISBN 9780815160038.
  9. ^ a b c Thilander, Birgit; Lennartsson, Bertil (2002-09-01). "A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition--occlusal and skeletal characteristics of significance in predicting the long-term outcome". Journal of Orofacial Orthopedics. 63 (5): 371–383. doi:10.1007/s00056-002-0210-6. ISSN 1434-5293. PMID 12297966. S2CID 21857769.
  10. ^ Thilander, Birgit; Wahlund, Sonja; Lennartsson, Bertil (1984-01-01). "The effect of early interceptive treatment in children with posterior cross-bite". The European Journal of Orthodontics. 6 (1): 25–34. doi:10.1093/ejo/6.1.25. ISSN 0141-5387. PMID 6583062.
  11. ^ Allen, David; Rebellato, Joe; Sheats, Rose; Ceron, Ana M. (2003-10-01). "Skeletal and dental contributions to posterior crossbites". The Angle Orthodontist. 73 (5): 515–524. ISSN 0003-3219. PMID 14580018.
  12. ^ Bresolin, D.; Shapiro, P. A.; Shapiro, G. G.; Chapko, M. K.; Dassel, S. (1983-04-01). "Mouth breathing in allergic children: its relationship to dentofacial development". American Journal of Orthodontics. 83 (4): 334–340. doi:10.1016/0002-9416(83)90229-4. ISSN 0002-9416. PMID 6573147.
  13. ^ a b Ogaard, B.; Larsson, E.; Lindsten, R. (1994-08-01). "The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3-year-old children". American Journal of Orthodontics and Dentofacial Orthopedics. 106 (2): 161–166. doi:10.1016/S0889-5406(94)70034-6. ISSN 0889-5406. PMID 8059752.
  14. ^ Piancino, Maria Grazia; Kyrkanides, Stephanos (2016-04-18). Understanding Masticatory Function in Unilateral Crossbites. John Wiley & Sons. ISBN 9781118971871.
  15. ^ Brin, Ilana; Ben-Bassat, Yocheved; Blustein, Yoel; Ehrlich, Jacob; Hochman, Nira; Marmary, Yitzhak; Yaffe, Avinoam (1996-02-01). "Skeletal and functional effects of treatment for unilateral posterior crossbite". American Journal of Orthodontics and Dentofacial Orthopedics. 109 (2): 173–179. doi:10.1016/S0889-5406(96)70178-6. PMID 8638566.
  16. ^ Pullinger, A. G.; Seligman, D. A.; Gornbein, J. A. (1993-06-01). "A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features". Journal of Dental Research. 72 (6): 968–979. doi:10.1177/00220345930720061301. ISSN 0022-0345. PMID 8496480. S2CID 25351006.
  17. ^ COSTEA, CARMEN MARIA; BADEA, MÎNDRA EUGENIA; VASILACHE, SORIN; MESAROÅž, MICHAELA (2016-01-01). "Effects of CO-CR discrepancy in daily orthodontic treatment planning". Clujul Medical. 89 (2): 279–286. doi:10.15386/cjmed-538. ISSN 1222-2119. PMC 4849388. PMID 27152081.
  18. ^ Kennedy, David B.; Osepchook, Matthew (2005-09-01). "Unilateral posterior crossbite with mandibular shift: a review". Journal (Canadian Dental Association). 71 (8): 569–573. ISSN 1488-2159. PMID 16202196.
  19. ^ Nielsen, H. J.; Bakke, M.; Blixencrone-Møller, T. (1991-12-01). "[Functional and orthodontic treatment of a patient with an open bite craniomandibular disorder]". Tandlaegebladet. 95 (18): 877–881. ISSN 0039-9353. PMID 1817382.
  20. ^ Lindner, A. (1989-10-01). "Longitudinal study on the effect of early interceptive treatment in 4-year-old children with unilateral cross-bite". Scandinavian Journal of Dental Research. 97 (5): 432–438. doi:10.1111/j.1600-0722.1989.tb01457.x. ISSN 0029-845X. PMID 2617141.
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