Correction of maxillary hypoplasia with MSE (Maxillary Skeletal Expander) and facemask supported by mini-implants

Maxillary constriction is defined as a transverse deficiency of multifactorial etiology. The primary objective of the Maxillary Skeletal Expander II (MSEII) is to widen the maxilla by separating the midpalatal suture, maximizing skeletal expansion while minimizing dentoalveolar expansion. Facemask (FM) therapy stimulates anterior maxillary growth by applying traction forces directly to the bone via temporary anchorage devices (TADs) or dental anchorage. The combination of MSEII and FM has proven effective in correcting both transverse maxillary deficiencies and sagittal discrepancies in growing patients, particularly in Class III malocclusions, promoting forward maxillary projection. This case report presents a 12-year-old male patient with skeletal Class I malocclusion, a tendency toward Class III, and maxillary constriction. A combined approach using skeletal expansion with MSEII and FM was employed to correct the transverse maxillary deficiency and improve the sagittal relationship between the maxilla and mandible. During phase I of the treatment, mini-implants and TADs were placed, and the facemask was used for 14-16 hours daily for seven months. Following maxillary expansion and advancement, significant improvements were achieved in the facial profile, occlusal relationship, and dental alignment. Clinical results revealed a maxillary expansion of 7.5 mm, increased facial convexity, and alleviation of severe crowding. This therapeutic approach provided a stable and less invasive correction of the malocclusion, avoiding the need for future orthognathic surgery while enhancing both function and aesthetics.