Correcting posterior crossbites complicated by class III malocclusions (A new technique)
TThe objective of this study is to introduce a simplified alternative approach to the current modality used in posterior crossbites correction. It is believed that the interlocking relation of posterior teeth cusps, prevents transverse forces of the palatal expanders from eliciting the desired movement, rendering the crossbite correction an oranous task for orthodontists. Thus eliminating this cuspal blockage constitutes a key step to developing a simpler approach for correction. This diagnostic concept has lead the way to formulating an alternative, and clinically convenient treatment technique that not only corrects posterior crossbites, but also effectively corrects the often coexisting class III malocclusion simultaneously. Building composite bite raisers on mandibular posterior teeth, along with the intrusive effects of the V Bends on super elastic wires, disengage the blocked cusps of posterior teeth, stop the patient's mandibular shifted occlusion making any transverse corrective forces more effective in moving the malposed teeth segments. This methodical and clinically applicable technique utilizes a solid force system that delivers expanding constricting mechanics acting on buccal, rather than the palatal sides of posterior teeth, launched by placing lasting intraoral V Bends on super elastic archwires, using the Bendistal Pliers* Whereas these V Bends create light and consistent, apically directed forces on both, mandibular and maxillary anterior teeth to intrude and disengage them for the class III correction, an equal and opposite side effect forces intrudes and disengages posterior teeth cusps helping the correction of posterior crossbites in the same time. This article describes in detail, the biomechanical effects and feasibility of this technique, and presents data of patients that were successfully treated during their routine adjustment visits. Correspondence to: Suhail A. Khouri, DDS, Orthodontics, 524 Dietrich RD, Ballwin, Missouri, Saint Louis 63024, USA, E mail: suhailkhouri@sbcglobal.net