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

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.

Tooth Complications after Orthodontic Miniscrews Insertion

“…Positioning is the major challenge in applying OMs. The rate of success of this technique is strictly conditioned by the site of insertion, angulations, depth of insertion, bone thickness, and design of the screw, e.g., diameter, dimension, and length [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

The Use of TADs in the Mandibular Arch to Prevent Proclination of the Lower Incisors during the Use of the Mini Scope Herbst Appliance

“…Unfortunately, exteriorising the force at the level of the definitive molars leads to a distalising vector that is charged to the upper arch and a mesialising one to the lower arch which then leads to the proclination of the lower incisors, more so than with any other functional appliances [19,20]. In recent years, in attempts at reducing the negative effects on Case Reports in Dentistry the patient's teeth, many appliances supported by temporary anchorage devices (TADs) have appeared, especially for those concerning rapid palate expanders [21,22] including appliances to achieve sagittal corrections, such as the Herbst one [23,24]. The latter allows a considerable reduction in the proclination of the lower incisors and attempt to provide the greatest skeletal effect possible.…”