A full digital workflow for planning nonsurgical palatal expansion in a skeletal class III adult patient

To describe the newest available digital technology applied in a complex orthodontic clinical case. This case report presented the treatment of a 40-year-old female patient with class III skeletal malocclusion, an open bite, and vertical growth pattern. She was managed with nonsurgically palatal expansion and dental aligners. The context of anterior aesthetics the patient presented clinical crowns too short and altered width/length ratio. The authors acquired and integrated the three-dimensional digital data provided by intraoral scans (i700, Medit, Seoul, Korea), facial scans ( RAYFace, Ray Corp., Seoul, Korea), and cone-beam computed tomography (Hyperion X9, MyRay, Imola-BO, Italy), and the mandibular movement was recorded and measured using the JMA + system (Zebris Medical GmbH, Germany). Two mini-implants were inserted using digital implant planning data. After palatal expansion, dental arch expansion was completed with aligner (Invisalign, Align Technology, Santa Clara, CA, USA), and indirect ceramic laminates were applied to improving anterior aesthetics and function. The orthodontic treatment performed had its objectives achieved and provided functional and esthetic improvements. The use of microimplants allows for the achievement of skeletal anchorage without the need of complex surgical procedures. The use of aligners combined with palatal expander was shown to be a useful device for orthodontic correction. The advantages of digital planning of a complex orthodontic case are mainly the efficacy of communication with the patient who can be shown a preview of the result and with the dental team, providing all information necessary to make a correct plan of treatment and therapy.