Case Report
Complete Maxillary Crossbite Correction with a Rapid
Palatal Expansion in Mixed Dentition Followed by a Corrective
Orthodontic Treatment
Orlando Motohiro Tanaka,
1,2
Isabelle Adad Fornazari,
3
Ariane Ximenes Graciano Parra,
4
Bruno Borges de Castilhos,
4
and Ademir Franco
5,6
1
Graduate Dentistry Program in Orthodontics, Pontif´ ıcia Universidade Cat´ olica do Paran´ a, Rua Imaculada Conceic ¸˜ ao 1155,
80215-901 Curitiba, PR, Brazil
2
Postdoctoral Fellowship at Te Center for Advanced Dental Education, Saint Louis University, St. Louis, MO, USA
3
Dentistry, Pontif´ ıcia Universidade Cat´ olica do Paran´ a, Curitiba, PR, Brazil
4
Orthodontics, Pontif´ ıcia Universidade Cat´ olica do Paran´ a, Curitiba, PR, Brazil
5
Department of Oral Health Sciences, Forensic Dentistry, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
6
Stomatology, Pontif´ ıcia Universidade Cat´ olica do Paran´ a, Curitiba, PR, Brazil
Correspondence should be addressed to Orlando Motohiro Tanaka; tanakaom@gmail.com
Received 6 February 2016; Revised 24 March 2016; Accepted 29 March 2016
Academic Editor: H¨ usamettin Oktay
Copyright © 2016 Orlando Motohiro Tanaka et al. Tis is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Tis case report presents the interceptive orthodontic treatment of a boy, aged 8 years 4 months with a Class I malocclusion with
severe transverse maxillary defciency and complete maxillary crossbite and correction using Haas expansion and fxed appliance.
Te treatment goals were to correct the posterior crossbite and anterior crossbite and restore the normality of the dentition and
occlusion. In phase I, the patient was treated with a modifed Haas-type palatal expander, which provided a clinically signifcant
palatal expansion and increased the maxillary arch perimeter with favorable conditions for orthodontic treatment with fxed
appliances in phase II. Te optimization of E-space and the use of intermaxillary Class III elastics helped to maintain the mandibular
incisors upright. A removable wraparound type appliance and a bonded lingual canine-to-canine retainer were used as retention.
Although the literature has reported a high rate of relapse afer palatal expansion, afer 2 years 9 months of posttreatment follow-up,
the occlusal result was stable and no skeletal reversals could be detected.
1. Introduction
Te posterior crossbite is one of the most frequent malocclu-
sions in orthodontics [1], and its possible etiologies include
prolonged retention or loss at an early age of deciduous teeth,
crowding, clef palate, genetic factors, tooth-size arch-length
discrepancies, abnormalities in tooth morphology, eruption
sequence, thumb sucking habits, and mouth breathing during
critical growth periods [2].
Te rapid palatal expansion (RPE) is ofen used to
expand the maxilla in patients with mixed dentition posi-
tively impacting the treatment of related defciencies [3, 4].
Specifcally, this technique may be used to correct transverse
and sagittal crossbite, generating space in the dental arch and,
consequently, solving cases of borderline crowding [5].
Te RPE is extremely useful for the treatment of Class III
patients and cases of real and relative maxillary defciencies
[6]. Occlusal acrylic splints are considered the most efective
devices for RPE in young patients because they produce
therapeutic efects that are not only limited to the correction
of crossbite or the increase in arch width [5, 7].
Posterior crossbite and anterior crossbite do not have a
spontaneous correction and should be treated with maxillary
expansion as early as possible, afer an accurate diagnosis
with the patient in centric relation [8] and treatment planning
Hindawi Publishing Corporation
Case Reports in Dentistry
Volume 2016, Article ID 8306397, 6 pages
http://dx.doi.org/10.1155/2016/8306397