Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Sep 30:2021:3883187.
doi: 10.1155/2021/3883187. eCollection 2021.

A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite

Domenico Aiello  1 , Riccardo Nucera  2 , Stefania Costa  2 , Michele Mario Figliuzzi  1 , Sergio Paduano  1
Affiliations
Case Reports

A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite

Domenico Aiello et al. Case Rep Dent. .

Abstract

Monolateral and bilateral crossbites are amongst the most frequent forms of malocclusion in the world population. The lack of early correction of this type of malocclusion leads to the partial or total ossification of the sutures which then require surgical treatment in adult patients. In recent years, devices on minipalatal screws have noticeably increased the time window in which it is possible to correct these types of alterations. In this case report, we show how it is possible to correct a third-class skeletal malocclusion associated with a posterior bilateral crossbite in a young woman using a rapid expander on miniscrews and fixed orthodontic device to finalise the process. The procedure for the insertion of the palatal screws was aided by the use of a digitally printed surgical guide, and the appliance was applied in the same sitting thanks to the use of a digital flow software and a systematic easy driver. The CBCT scans show how the orthopaedic expansion of the upper maxilla was obtained without any important alterations that damaged the permanent teeth. This case report wishes to demonstrate how easy and predictable it can be to resolve cases of this type with optimal aesthetic and functional results even when body growth has ended.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Initial lateral cephalogram.
Figure 2
Figure 2
Initial intraoral photographs.
Figure 3
Figure 3
Initial extraoral photographs.
Figure 4
Figure 4
Initial OPT.
Figure 5
Figure 5
CBCT suture evaluation.
Figure 6
Figure 6
Implants digital planning.
Figure 7
Figure 7
Operative sequence.
Figure 8
Figure 8
Implants and hybrid RME placed.
Figure 9
Figure 9
Before expansion treatment.
Figure 10
Figure 10
Superimposition of CBTC, light blue pre- and violet postexpansion.
Figure 11
Figure 11
Final lateral cephalogram.
Figure 12
Figure 12
Final intraoral photographs.
Figure 13
Figure 13
Final extraoral photographs.
Figure 14
Figure 14
Final OPT.
Figure 15
Figure 15
Final virtual models.
Figure 16
Figure 16
Expansion virtual evaluation.
Figure 17
Figure 17
First molar torque evaluation.
Figure 18
Figure 18
Cephalometric superimposition.
See this image and copyright information in PMC

References

    1. Paduano S., Rongo R., Bucci R., et al. Is there an association between various aspects of oral health in southern Italy children? An epidemiological study assessing dental decays, periodontal status, malocclusions and temporomandibular joint function. European Journal of Paediatric Dentistry . 2018;19(3):176–180. doi: 10.23804/ejpd.2018.19.03.2. - DOI - PubMed
    1. Giudice A. L., Spinuzza P., Rustico L., Messina G., Nucera R. Short-term treatment effects produced by rapid maxillary expansion evaluated with computed tomography: a systematic review with meta-analysis. The Korean Journal of Orthodontics . 2020;50(5):314–323. doi: 10.4041/kjod.2020.50.5.314. - DOI - PMC - PubMed
    1. Zuccati G., Casci S., Doldo T., Clauser C. Expansion of maxillary arches with crossbite: a systematic review of RCTs in the last 12 years. European Journal of Orthodontics . 2013;35(1):29–37. doi: 10.1093/ejo/cjr140. - DOI - PubMed
    1. Huang J., Li C. Y., Jiang J. H. Facial soft tissue changes after nonsurgical rapid maxillary expansion: a systematic review and meta-analysis. Head & Face Medicine . 2018;14(1):p. 6. doi: 10.1186/s13005-018-0162-8. - DOI - PMC - PubMed
    1. Lagravere M. O., Major P. W., Flores-Mir C. Long-term skeletal changes with rapid maxillary expansion: a systematic review. The Angle Orthodontist . 2005;75(6):1046–1052. doi: 10.1043/0003-3219(2005)75[1046:LSCWRM]2.0.CO;2. - DOI - PubMed

Publication types

LinkOut - more resources