A Small Maxilla

Orthodontic Tips October 4, 2011

Does it matter if facial bones aren’t balanced?

Usually, yes it does.

The effect of unbalanced facial bones is often seen in the teeth.

Here is a case of a patient who is 7 years and 10 months and has a small upper jaw (maxilla).

There are three dental problems here because of the small upper jaw. First is the obvious crossbite of the central incisors on the left side. Second is the gum loss on the front of the lower left central incisor because it has been pushed forward outside of the jaw bone. Finally and not so obvious is ectopic eruption of the upper left first molar erupting underneath the upper left second primary molar.

The correction is easy and straightforward. The upper and lower primary cuspids will be extracted to create space for incisor alignment. Then a steel button will be bonded to the upper left first molar. Finally, a removable appliance will be made with a bite plane and spring to correct the anterior crossbite with an additional spring to move the ectopically erupting molar distally.

Fortunately this patient was referred at the age of 7 years so we can take care of these small problems before they turned into big problems.

Have a great week.


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