The Hybrid Rapid Palatal Expansion Supported Camouflage Treatment

Hybrid RPE (rapid palatal expansion) can be a valid alternative to achieve a better skeletal response for patients with maxillary insufficiency and posterior crossbite in Class III correction. A 12-year-old female patient presented with a concave facial profile and maxillary retrognathia (SNA: 76 ̊, SNB: 80 ̊). The standard Hyrax screw (12 mm) combined with specially designed reusable sleeves (N. Erverdi) ensured easy fabrication of a hybrid RPE appliance. 2 stainless steel mini screws (2 mm x 11 mm Ø) were used to anchor the appliance on the anterior palate. Activations were performed 2 times per day. According to posteroanterior cephalometric radiography, the expansion of the nasal floor was 3 mm, maxillary expansion was 7 mm and intermolar distance increase was 10 mm after the 19-day expansion procedure. Subsequently, treatment continued with fixed orthodontic therapy. At the end of the treatment, 1.3 mm advancement of the maxilla was achieved (as measured by N⊥A). SNA angle increased by 1 ̊. There was a 4.9 ̊ improvement in the total facial convexity, and the skeletal profile angle reduced from 191 ̊ to 187 ̊. Camouflage treatment is preferred based on the patient’s age and family preferences. Hybrid RPE provides skeletal expansion and facial profile improvement, reinforcing its effectiveness as a non-surgical alternative for treating Class III malocclusion. The Hybrid RPE supported camouflage treatment seems to provide adequate amount of maxillary expansion and enhancement of the facial profile in a 12-year-old subject.