A common orthodontic finding is the narrow upper jaw with the unilateral cross bite in the lower jaw, which then deviates a few millimetres to one side. The treatment consists in widening the upper jaw, which can be attempted with removable as well as fixed appliances. In this high-quality randomized study, the authors compared both methods and also investigated whether treatment by general dentists or orthodontists was more economical. The treatment with fixed appliances was most successful with orthodontists who treated 100% of the children successfully. In contrast, dentists achieved a success rate of only 85% with fixed appliances. With the removable appliance, both dentists and orthodontists achieved success rates of about 65%. The fixed appliance was therefore always more reliable and safer than the removable appliance.
Not surprisingly, the authors also found that the fixed appliance for widening the upper jaw was also significantly more economical than the removable one. It should only be mentioned in passing that here too, speialized orthodontists performed better than dentists, for whom orthodontics is only a small part of their work.
In terms of success and economy, it is therefore best to have a lateral cross bite corrected by the orthodontist with a fixed appliance. Removable treatment attempts fail by one third and cause higher costs, not least, because of necessary secondary treatments.
More information: Sollenius O, Petren S, Bondemark L. An RCT on clinical effectiveness and cost analysis of unilateral posterior crossbite with functional shift in specialist and general dentistry. Eur J Orthod 2020;42: S. 44-51