Abordagem precoce de uma mordida cruzada anterior funcional com pistas planas indiretas: relato de caso

Abstract

A anterior crossbite consists of an abnormal vestibulo-lingual relationship between the upper and lower incisors. This malocclusion can be classified as dental, skeletal, or functional. The Planas track technique was proposed by Planas for the treatment of functional anterior crossbite, based on the concepts of neuroocclusal rehabilitation, in which resin composite-made planes act as a barrier to prevent the mandible from returning to the habitual mandibular deviation position. The objective of this study is to report a clinical case of anterior crossbite, with an early approach using Planas indirect track, in a 3 years and 8 months old male patient diagnosed with functional anterior crossbite. Initially, in maximum intercuspation habit (MIH), it was possible to observe mandibular protrusion, and by manipulating the patient's mandible, bringing the condyles into centric relation (CR), premature top-to-top contacts were noted on the anterior teeth, which allowed for the indication of treatment with Planas indirect track and a favorable prognosis. Four Planas indirect track were then made for teeth 51, 52, 61, and 62. Immediately after the installation of the guides, a top-to-top anterior bite relationship was observed. The patient then started the neuroocclusal reprogramming stage, and it was possible to observe, through follow-ups at 15 days, 45 days, 6 months, 1 year, and 2 years after the installation of the guides, the correction of the anterior crossbite, as well as aesthetic and functional impact, also evidenced through speech therapy follow-up, which reports improvement in the pronunciation of some phonemes and communication. The case has been monitored for 2 years, and such follow-up should be periodically performed until the complete establishment of permanent dentition. It is concluded that the reported case demonstrates that early treatment of functional anterior crossbites provides significant aesthetic and functional benefits, as well as greater possibilities for balance in the growth of the bony bases.