An adult case of unilateral posterior crossbite caused by maxillary transverse deficiency treated with miniscrew-assisted rapid palatal expansion

This report describes the successful treatment of an adult case of unilateral posterior crossbite caused by maxillary transverse deficiency with miniscrew-assisted rapid palatal expansion (MARPE). A female patient aged 35.5 years presented with masticatory disturbance, facial asymmetry, and unilateral posterior crossbite. She was diagnosed with unilateral posterior crossbite with a skeletal Class III jaw-base relationship and high mandibular plane angle. Her maxillary right and mandibular bilateral second premolars were congenitally absent, and the maxillary left second premolar was impacted. After the improvement of the posterior crossbite with MARPE, 0.018” slot lingual brackets were placed on the maxillary and mandibular dentition. The total active treatment period was 22 months, and acceptable occlusion with a functional Class I relationship was achieved. Pretreatment and posttreatment cone-beam computed tomography images showed the disarticulation of the midpalatal suture after MARPE, and changes in the dental and nasomaxillary structures, nasal cavity, and pharyngeal airway. The case results demonstrate that MARPE produces greater skeletal expansion with minimal buccal tipping of the molars. MARPE may be effective for the treatment of maxillary transverse deficiency in adult patients.

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