The Best Method to Correct an Anterior Crossbite-a Systematic Review of Randomized Clinical Trials

Objectives: To investigate and identify the best intervention to correct the anterior crossbite in term of quality of life, effectiveness, treatment time, long term stability and cost minimization
Methods: Inclusion criteria and search method: RCTs comparing two orthodontic appliances to correct an anterior crossbite with or without a functional shift in the mixed dentition were included in this systematic review. A search strategy was implemented using both manual hand search and electronic databases, including Cochrane database of clinical trials, PubMed, ScienceDirect, Scopus and Ebsco. Risk of bias of eligible studies to be included in the final analysis was assessed independently by two authors using Cochrane risk of bias tool.


Results: A total of 522 articles were identified in both manual and electronic searches as well as by checking the reference lists of the final articles to be included in the study. Only 7 RCTs met the inclusion criteria and thus were included in the final analysis. All but one of the 7 RCTs were judged to be of high quality except. No statistical methods were employed to combine the studies due to the heterogeneities of the studies.
Conclusions: Fixed appliance was more cost-effective than a removable appliance in the correction of an anterior crossbite with a functional shift. There was no significant difference in terms of quality of life, pain intensity or long-term stability between the two appliances. On the other hand, both removable appliance and cemented bite pads were equally effective in the correction of an anterior dental crossbite without having any side effect.