Kennedy David B, Osepchook Matthew
J Can Dent Assoc. 2005 Sep;71(8):569-73.
Based on this literature review, early orthodontic treatment of unilateral posterior crossbites with mandibular shifts is recommended. Treatment success is high if it is started early. Evidence that crossbites are not self-correcting, have some association with temporomandibular disorders and cause skeletal, dental and muscle adaptation provides further rationale for early treatment. It can be difficult to treat unilateral crossbites in adults without a combination of orthodontics and surgery. The most appropriate timing of treatment occurs when the patient is in the late deciduous or early mixed dentition stage as expansion modalities are very successful in this age group and permanent incisors are given more space as a result of the expansion. Treatment of unilateral posterior crossbites generally involves symmetric expansion of the maxillary arch, removal of selective occlusal interferences and elimination of the mandibular functional shift. The general practitioner and pediatric dentist must be able to diagnose unilateral posterior crossbites successfully and provide treatment or referral to take advantage of the benefits of early treatment.
基于这篇文献综述，建议对伴有下颌移位的单侧后牙反合进行早期正畸治疗。如果早期开始治疗，成功率很高。反合不会自行纠正、与颞下颌关节紊乱有一定关联且会导致骨骼、牙齿和肌肉适应性改变的证据，为早期治疗提供了进一步的理论依据。对于成年人，若不结合正畸和手术治疗单侧反合可能会很困难。最合适的治疗时机是患者处于乳牙晚期或混合牙列早期，因为在这个年龄组中扩弓方式非常成功，扩弓后恒切牙会获得更多空间。单侧后牙反合的治疗通常包括上颌牙弓的对称扩弓、去除选择性咬合干扰以及消除下颌功能移位。全科医生和儿童牙医必须能够成功诊断单侧后牙反合，并提供治疗或转诊，以便利用早期治疗的益处。
