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Abstract

A 13-year-old female patient presented with a chief complaint of anterior crossbite and chin prognathism. She had a skeletal Class III relationship with a brachyfacial vertical pattern. Anterior crossbite exhibited maximum intercuspation–centric relation shift, leading to an edge to-edge incisal position. On the basis of this patient’s chronological age, it was too late to perform conventional early treatment of Class III cases, which includes rapid palatal expansion combined with facemask or chincap therapy. After discussing treatment options with the patient and her parents, we decided to try combined maxillary skeletal expander and facemask treatment with an alternating rapid maxillary expansion and constriction protocol to facilitate mid-face protraction. After anterior crossbite correction, an upper 2 × 6 appliance was used for anterior teeth alignment. Active treatment time was 14 months and the patient achieved considerable maxillary traction as well as profile change. The patient and her parents were satisfied with the treatment result although the uncertain residual mandibular growth requires ongoing monitoring.

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