The Risks of Long-Term CR-CO Shifts

When tackling CR-CO shifts in patients, knowing about the potential long-term risks is important. Fortunately, a research paper by Clujul Med. dived into this in 2016, entitled Effects of CO-CR discrepancy in daily orthodontic treatment planning, and we’ve summarized some of the key findings of this report as follows.
What are the Long-Term Risks of CR-CO Shifts?
When coming up with the most effective treatment plan for an orthodontics patient, considering the consequences of long-term CR-CO shifts is highly recommended. Indeed, long-term shifts (in adults especially) can potentially result in disorders of the temporomandibular joint.
As such, steps should be taken to ensure the patient is put into a comfortable, symmetrical bite position when articulating them. It’s worth noting that adults should have a full CBCT read to check whether there is asymmetry; this may not always be visibly obvious.
In children with a CR-CO shift, you will usually notice the midline deviation skeletally, causing them to be asymmetric. This can result in asymmetric growth, which likely isn’t treatable down the line; as such, catching and treating these in Phase 1 is crucial.
Tackling CR-CO Shifts with Orthodontics Cases
Unfortunately, many people start orthodontics cases in a shift; however, unraveling the shift first may be all that’s necessary to correct the bite. As such, before starting on these cases, make sure the shift is resolved initially before taking further steps.
Sometimes, you may alternatively want to consider doing initial alignment before fixing the bite, CR, sagittal, transverse, or vertical until you have unraveled the shift. Trying to do everything upfront will likely only lead to complications or unpredictable progression.
It’s worth noting that you may need to redo your ClinChecks and initial articulations in CR, to ensure that midlines are correct. Always take scans and photos in CR as well to help with treatment planning.
At the end of the day, though, some cases may not be fixable with orthodontics alone. If you are unsure, contact our experts here at Straight Smile Solutions for support; we can help you ascertain whether you should take the case or if you should be sending the patient to a professional orthodontist or an oral surgeon.