The tongue blade is an effective method of treatment during the early
phase of eruption, however, it requires total co-operation from the
patient, which could not be achieved in our case. The reverse stainless
steel crown is a well known method. The chief disadvantage of this
method is the difficulty in adapting a preformed crown to fit the tooth
in crossbite. Further more, the reverse stainless steel crown is an
unesthetic treatment that is often rejected by the children and their
relatives. [8]
Because of the disadvantages of the methods mentioned above, a
cemented acrylic bite plane was given in Case 1. The lower inclined
plane caps the lower incisors and is inclined at about 450 to the
occlusal plane. On closing the upper incisors, which formerly occlude
behind the lower incisors , bite on the inclined plane and the pressure
of the bite (P) divides into two force vectors P1 and P2(Figure 1). The
pressure (P1) proclines the upper incisors. The Pressure (P2) intrudes
the incisors. The steeper the plane the greater the forward pressure on
the maxillary incisors. The advisable angle is 45° [p]
So, desirable results in Case 1 were seen within seven days itself with
good patient compliance.
In Case 2, since there was sufficient space for the maxillary central
incisor to move labially, a Hawley’s appliance with a double
cantilever spring was given. A maxillary posterior bite plate was
inserted to allow clearance for the crossbite correction. [10] Though
the patient’s compliance was good, the desired results were seen
within 4 weeks.