Prosthetic technique to chance the anterior crossbite and the esthetics

A 54 years old partially edentulous female patient came to the office complaining of both esthetic and functional problems. The clinical examination showed the abnormal labiolingual relationship between the maxillary and mandibulary incisors and canines (anterior crossbite) and the generalized mobility. The X-ray exam exposed dramatically periodontal loss partly due to the traumatic occlusion. This patient refused both orthognathic and implant options. The patient needed a full mouth oral reconstruction. She accepted the prosthetic solution which was correcting the underbite - class 3 occlusion using porcelain metal dental bridges and removable partial dentures. The occlusion has been functionally restored as a part of the prosthetic treatment. Photos, X-rays and mounted study models were used to document the case in the beginning. The occlusal vertical dimension was evaluated and it was decided to remain the same. The acrylic temporary bridges were constructed in order to keep the occlusal vertical dimension and to test the esthetic results. The final prosthetic restoration implied two removable partial dentures with snap and magnets attachments. The patient wanted a better esthetic appearance so, accordingly, the color of the porcelain fused to metal crowns and bridges was brighter. Changing the anterior occlusion enabled her to change the smile habit from labial to a dental one, exposing the teeth without caring of the appearance. Due to the fact that the upper lip was better sustained, the facial and profile aspect improved. The anterior crossbite occlusion was transformed using prosthetic methods in edge to edge occlusion in order to obtain space for the lingual bar, a better esthetic appearance and a more favorable transmission of the occlusal load to the roots. This procedure is an effective method for treating anterior dental crossbite. Palabras clave: anterior crossbite, traumatic occlusion, prosthetic methods, esthetics