ResumoA má oclusão de Classe III de Angle é caracterizada por uma relação dentária anteroposterior inadequada, que pode ou não estar acompanhada de alterações esqueléticas. Em geral, o aspecto facial fica bastante comprometido, principalmente quando associada à deficiência no terço médio da face, sendo esse, na maioria das vezes, o principal fator que motiva o paciente a procurar tratamento. Este caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria livre, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.Palavras-chave: Má oclusão Classe III de Angle. Tração maxilar. Disjunção maxilar.

Posterior crossbite might cause serious long-term functional problems if not early treated. Nevertheless, in older patients, treatment might include palatal expansion in order to correct such malocclusion. In view of the above, this article aims at reporting late correction of bilateral posterior crossbite associated with Angle Class III malocclusion, right subdivision, with consequent midline shift (good skeletal pattern). The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), with DI equal to or greater than 10, as a requirement for the title of certified by the BBO.

Introduction The diversity of the proposed techniques in the treatment of maxillary transverse deficiency in adults reflects the conflicting opinions about the primary area of resistance to maxillary expansion in the craniofacial skeleton. In order to evaluate the efficiency of the surgical expansion in which no osteotomies of the pterygomaxillary junction were made, we have carried out a retrospective study with 14 patients with maxillary transverse deficiency, who were treated from 2003 to 2006. Material and methods In the study, models were made prior to and after surgery, and the intercanine and intermolar distances and the improvement of the interocclusal relationships were analyzed. Breathing function and the complications that occurred during and after the surgeries were also analyzed. Results All expansions were carried out according to pre-surgical planning so that expansion completely corrected the crossbite, resulting in the desired final occlusion for all patients. Intraoperative complications were limited to one Hyrax appliance deformation. Two patients had minor postoperative complications that included wound dehiscence and pain. Improvements in nasal breathing were observed in all patients that complained of breathing problems prior to the surgery. Conclusion The satisfactory results obtained turns the surgical protocol described in this study recommended for the treatment of maxillary transverse deficiency in adults. Importantly, we found that pterygomaxillary osteotomy is not essential for maxillary expansion. The morbidity of the procedure was low with fairly minor complications, and surgically assisted rapid maxillary expansion was shown to improve nasal breathing.

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