Maxillary Orthopedic Expansion with Periodontally Accelerated Osteogenic Orthodontics

Abstract

Background: A transverse skeletal discrepancy of the adult patient compromises occlusal stability and possibly implies muscular, articular, and aesthetic repercussions that depend on its severity. Historically, the treatment of transverse skeletal discrepancy has been accompanied by orthognathic surgery to disrupt sutures in order to expand the maxilla with disjunction devices. Purpose: To analyze current therapeutic approaches, such as periodontally accelerated osteogenic orthodontics, which become alternative treatment options for complex cases, decrease the severity of surgical procedures and adverse effects on the periodontal supporting tissue, improve the prognosis, and even reduce duration of treatment. Results: This report present the case of an adult female patient with complete unilateral left posterior crossbite and limitations of incisors’ crown/root ratio. The patient was successfully treated with transversal growth stimulation of the second quadrant by orthopedic expansion, performed immediately after corticotomies and lyophilized bone graft placement, followed by orthodontic treatment and multiloop edgewise arch wire technique. KEYWORDS transverse skeletal discrepancy; posterior crossbite; maxillary expansion; corticotomies; adult patient; multiloop edgewise arch wire; accelerated osteogenic orthodontics