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Reverse-Sequencing Chewing Patterns Evaluation in Anterior Versus Posterior Unilateral Crossbite Patients.
Reverse-Sequencing Chewing Patterns Evaluation in Anterior Versus Posterior Unilateral Crossbite Patients.
Reverse-Sequencing Chewing Patterns Evaluation in Anterior Versus Posterior Unilateral Crossbite Patients.
536541
1 of(2012)
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doi:10.1093/ejo/cjr109
Advance Access Publication 15 September 2011
2011. Published
Published by Oxford University Press on behalf of the European Orthodontic Society.
The Author 2011.
All rights reserved. For permissions, please email: journals.permissions@oup.com
It is well established that patients with a unilateral posterior crossbite exhibit reversesequencing chewing patterns when chewing on the affected side. The aim of the study was to compare
the prevalence of reverse-sequencing chewing cycles in patients with anterior versus posterior unilateral
crossbite during chewing soft and hard boluses. Eighty-six children (39 boys, 47 girls) were included
in the study: 26 (10.4 2.7 years) with unilateral anterior crossbite, 43 (10.2 4.2 years) with unilateral
posterior crossbite, and 17 (10.6 2 years) with normal occlusion were selected for the study. Mandibular
movements were measured with a kinesiograph (K7, Myotronics Inc. Tukwila). The kinematic signals
were analyzed using custom-made software. The results showed a low prevalence of reverse-sequencing
chewing cycles in patients with anterior crossbite, without any signicant difference between sides and
with the control group, with both soft (P = 0.33) and hard (P = 0.29) bolus. The patients with posterior
unilateral crossbite showed a signicant higher prevalence of reverse-sequencing chewing cycles during
chewing on the crossbite side with respect to the non-crossbite side (P < 0.001) and to the control group
(P < 0.001). Comparing the patients with anterior versus posterior unilateral crossbite, a signicant
difference (P < 0.001) in the prevalence of reverse chewing cycles was demonstrated during chewing
on the posterior crossbite side only with both soft and hard bolus. In conclusion, patients with anterior
versus posterior unilateral crossbite show different functional characteristics depending on which dental
region is involved.
SUMMARY
Introduction
Crossbite is a common malocclusion developing at an early
stage of growth. It may involve the anterior and/or the
posterior regions of the dental arches.
The posterior unilateral crossbite has been dened as: a
malocclusion in which one or more deciduous or permanent
posterior upper teeth occlude in an abnormal buccal
palatal relationship with their corresponding lower teeth
(Daskalogiannakis and Miotti, 2001). It has been classied
by Bjork considering different regions of the occlusion and
has been dened as a malocclusion in the canine, premolar,
and molar regions, characterized by the buccal cusps of the
maxillary teeth occluding lingually to the buccal cusps of
the corresponding mandibular teeth (Bjrk et al., 1964).
The prevalence of unilateral posterior crossbite ranges from
8 to 16% (Thilander et al., 1984; Harrison and Ashby, 2008;
Perillo et al., 2010).
It is well established that patients with a unilateral posterior
crossbite exhibit reverse-sequencing chewing patterns when
chewing on the affected side only. Reverse-sequencing
chewing patterns are dyskinetic cycles characterized by a
reverse direction of closure and a severely unbalanced
muscular activation (Lewin, 1985; Ben-Bassat et al., 1993;
ANTERIOR
2 of 2 versus POSTERIOR CROSS-BITE
M. G. PIANCINO ET537
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M. G. PIANCINO3ETof
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3
ANTERIOR
versus POSTERIOR CROSS-BITE
538
ANTERIOR
4 of 4 versus POSTERIOR CROSS-BITE
M. G. PIANCINO ET539
AL.
ANTERIOR
versus POSTERIOR CROSS-BITE
540
M. G. PIANCINO5ETof
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Figure 3 Right unilateral posterior crossbite occlusion (A), reverse-sequencing chewing cycles during chewing
a hard bolus on the crossbite side (B), and chewing cycles with normal direction of closure during chewing on
the non-crossbite side (C). In the frontal plane, the masticatory pattern is seriously asymmetric; such functional
asymmetry should be prevented by early functional therapy.
Figure 4 Right unilateral anterior crossbite occlusion (A), chewing cycles during chewing a hard bolus, with
normal direction of closure on both the crossbite side (B), and the normal side (C).
ANTERIOR
6 of 6 versus POSTERIOR CROSS-BITE
M. G. PIANCINO ET541
AL.
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