Effects of functional orthodontic appliances in the correction of a primary anterior crossbite--changes in craniofacial morphology and tongue position.

Chin caps have been used for the correction of primary anterior crossbites, but previous studies of the treatment effects have highlighted problems such as pressure on the temporomandibular joint (TMJ). Therefore, to reduce pressure on the TMJ, a functional orthodontic appliance, the Yanagisawa Class III (YC3) shield was developed to improve the overjet in the primary dentition. The aim of this study was to determine the treatment effects of the YC3 in correcting a primary anterior crossbite compared with a chin cap. The pre- and post-treatment lateral cephalograms of 10 patients (5 male, 5 females) and 10 treated with a YC3 (5 males, 5 females) were compared in relation to craniofacial morphology and tongue position [the YC3 was used from 51 months of age +/- 7 months to 74 months of age +/- 12 months (i.e. for 23 +/- 9 months) and the chin cap from 53 months of age +/- 2 months to 75 months of age +/- 1 month (i.e. for 22 +/- 5 months)]. A Mann-Whitney U-test was used to determine any statistical differences. The YC3 group showed significantly higher values for gonial angle and U1 to SN (P < 0.05), and significantly lower values for interincisal and tongue position (P < 0.05), compared with the chin cap group. The results indicate that the use of the YC3 not only improves overjet, but also changes the tongue position. The findings also suggest that the YC3 results in functional effects on the skeletal system during the mid-growth period.