018 – Occlusal Trauma Of Anterior Crossbite Teeth

What is occlusal trauma?

Occlusal trauma is a dental term that refers to the damage incurred when teeth are left in traumatic occlusion without proper treatment. (Definition by Wikipedia)

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What is anterior Crossbite Teeth?

Crossbite is a form of malocclusion where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either close 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 dental arches. (Definition by Wikipedia)
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How does it happen?

When teeth are misalignment in the dental arch, the chewing or biting force applied on the teeth may not transmitted to the supporting alveolar bone through its root tip in straight direction, but through the root body in oblique direction. This will caused stress to build up on the alveolar bone near the neck of the tooth, which may further causing resorption of the alveolar bone, and result in gingival recession.

Case Report 1

A 17 years old young girl with misalignment of lower incisors, the lower left central incisor erupted slightly towards the lip. 018-Picture 3
Both upper left central incisor & lateral incisor are in crossbite position, which have an edge to edge bite during function, and eventually causing an occlusal trauma to lower left central incisor.
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. Some damaged on the lower left central incisor due to the traumatic occlusion, irregular incisor edge, enamel chipped off, cervical bone loss and gingival recession.  018-Picture 5

Case Report 2

A 8 years old boy with anterior crossbite of upper Right Central Incisor

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, which causing traumatic occlusion during chewing function. The Occlusal trauma already causing bone resorption and gingival recession of lower Right Central Incisor.
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Case Report 3

A 10 years old boy come for a routine check up, he is in mixed dentition.
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I noticed there are a traumatic occlusion during function. The permanent upper canine not erupted yet and therefor patient does not have proper anterior canine guidance during chewing. He then developed the habit to bite edge to edge on anterior incisors in order to cut the food.

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Stress built up at the neck of the tooth, gingival became thinner and reduced in blood supply, further lead to alveolar bone resorption and gingival recession.
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The occlusal trauma also causing some craze line inside the tooth structure, this line can be seen under blue LED light.

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Conclusion

Misalignment of teeth in the dental arches may lead to occlusal trauma, which may further causing damage to the tooth and supporting structure like alveolar bone, periodontal ligament and gum. Therefore, attention should be given to it and should be treated with orthodontic movement (braces) before severe irreversible damage occurred.

Prepared by
Dr Goon