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Dentistry · Orthodontics and paediatric dentistry: functional posterior crossbite
Sample itemAn 8-year-old has a unilateral posterior crossbite. At first contact the midlines coincide, but on full closure the lower midline shifts towards the crossbite side. What is the likely cause?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. A constricted maxilla causing an occlusal interference
In a functional crossbite, a narrow maxilla produces cuspal interference so the mandible deviates to one side to reach maximum intercuspation, giving a midline shift only on closure. Treatment is by maxillary expansion. A true skeletal asymmetry has a shift that persists in all positions.
Option by option
A. Unilateral early loss of lower primary molars in the arch
Tooth loss on one side does not produce an interference with a closure shift of this kind.
B. A constricted maxilla causing an occlusal interference (correct)
Correct. A narrow maxilla forces the mandible sideways to reach occlusion.
C. True skeletal asymmetry from condylar overgrowth on one side
Condylar overgrowth gives a constant asymmetry that persists in all jaw positions.
D. Habitual chewing on one side of the mouth only
Chewing habits may contribute, but the constricted maxilla is the underlying cause.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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