Use of Implant to Correct Cross Bite

A 42-year-old lady has cross bite at the right 1st and 2nd molars (Fig.1).  When the implant at #3 osteointegrates (Fig.2, 14), acrylic is added to the occlusal surface of the immediate provisional (11, 12) so that the cross bite is unlocked.  A lingual button (15) is placed on the buccal surface of an upper molar and the lingual surface of a lower molar.  An elastic is placed between the lingual buttons.  In 4.5 months, the cross bite is corrected (Fig.2).

Fig.3 shows the pre-orthodontic upper right arch.  There is wear facet on the lingual surface of each molar (*).  After limited ortho, the upper right arch is more or less normal (Fig.4).  To have maximal occlusal contact, the lingual cusps of the upper molars and the buccal cusps of the lower molars need occlusal equilibrium when regional ortho is finished (Fig.4,6 *, as compared to pre-ortho lower right arch in Fig.5).

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Xin Wei, DDS, PhD, MS 1st edition 12/17/2015, last revision 04/29/2017