MSE Combined With Invisible Orthodontic Treatment For Adult Skeletal III .

A retreatment 40 yr adult female with skeletal crossbite was always informed orthognathic surgery at other hospitals. Teeth 42 and 41 alveolar bone resorbed to a degree III with mobility. After our one and a half years of MSE and invisible orthodontic treatment, significant improvement was achieved. Concave profile, skeletal class III, protruded mandible, and left deviation of the jaw. Crossbite at anterior and right side on posterior, traumatic occlusion of the anterior teeth,15,35,45 were extracted at previous treatment, 25 impacted. Horizontal alveolar bone resorption, gingival recession,15 implants, and incomplete root canal treatment at teeth 36 and 46. Treatment plan: periodontal therapy before orthodontic treatment. First stage: maxillary skeletal expander(MSE) of the maxillary basal bone to correct posterior crossbite and improve midfacial concave. The second stage: invisible orthodontic treatment to correct anterior and posterior crossbite and refine occolusion. After 1.5 yr treatment, the patient's concave lateral profile significantly improved, following the anterior traumatic occlusion and posterior crossbite resolved, the mobility of the lower incisors has reduced from degree Ⅲ toⅠ. The patient’s concave facial profile improved obviously after MSE .However, cephalometric superimposition showed a slight forward movement of the maxilla and more of a clockwise rotation of the mandible. Establishing normal anterior overbite and overjet as well as good posterior occlusion. Maxillary skeletal expander(MSE) combined with invisible orthodontic treatment can reduce the likelihood of orthognathic surgery for skeletal Class Ⅲ patients in proper indication and can significantly improve orthodontic treatment effciency.