Long-term stability of Class III malocclusion treatment with maxillary transversal deficiency, short roots, gingival recession, and alveolar bone loss

Abstract

• The SARPE in a patient with short root, gingival recession, and alveolar bone loss. • SAPE in the absence of atresic morphology of the palate for a skeletal transverse discrepancy. • Long-term periodontal stability is achieved in the case of reduced periodontal support tissues. • Special care in orthodontic treatment of shortened roots and alveolar bone loss. Orthodontic treatment in patients with Class III malocclusion can be complex, particularly when associated with other problems. This case report describes the retreatment of a 32-year-old woman with Class III malocclusion, transverse maxillary deficiency, short roots, and gingival recession. The patient was retreated with fixed appliances combined with surgically assisted rapid palatal expansion. The results of the debonding were excellent esthetics, good intercuspation, gingival health with adequate overjet, and overbite. After 22 months of treatment, the proposed goals (dental Class III relationship correction and transverse maxillary deficiency) were obtained. After the 5-year follow-up, the sagittal and transverse relationship remained stable.