Unilateral cross bite treated by corticotomy-assisted expansion: two case reports

Ali H Hassan, Ali T AlGhamdi, Ahmad A Al-Fraidi, Aziza Al-Hubail, Manar K Hajrassy, Ali H Hassan, Ali T AlGhamdi, Ahmad A Al-Fraidi, Aziza Al-Hubail, Manar K Hajrassy

Abstract

Background: True unilateral posterior crossbite in adults is a challenging malocclusion to treat. Conventional expansion methods are expected to have some shortcomings. The aim of this paper is to introduce a new technique for treating unilateral posterior crossbite in adults, namely, corticotomy-assisted expansion (CAE) applied on two adult patients: one with a true unilateral crossbite and the other with an asymmetrical bilateral crossbite, both treated via modified corticotomy techniques and fixed orthodontic appliances.

Methods: Two cases with asymmetric maxillary constriction were treated using CAE.

Results: In both cases, effective asymmetrical expansion was achieved using CAE, and functional occlusion was established as well.

Conclusions: Unilateral CAE presents an effective and reliable technique to treat true unilateral crossbite.

Figures

Figure 1
Figure 1
Initial intra-oral composite photograph of case 1.
Figure 2
Figure 2
Initial study model of case 1.
Figure 3
Figure 3
The unilateral asymmetry of the upper arch is shown.
Figure 4
Figure 4
The lingually positioned lower right 2nd premolar and the rotation of the right 2nd molar, masked the severity of the cross-bite.
Figure 5
Figure 5
Initial cephalogram of case 1.
Figure 6
Figure 6
Initial OPG of case1.
Figure 7
Figure 7
Surgical procedure of CAE. A &B: buccal and palatal incisions are made. C & D: full thickness flap is reflected. E: selective alveolar decortications lines and points are made. F & G: bone graft is placed. H & I: flap is sutured back.
Figure 8
Figure 8
Heavy labial bow used as the expanding appliance for case 1.
Figure 9
Figure 9
OPG showing the use of a miniscrew to upright the lower left third molar.
Figure 10
Figure 10
Final intraoral composite photograph of case 1.
Figure 11
Figure 11
Final study model of case 1.
Figure 12
Figure 12
Final cephalogram of case 1.
Figure 13
Figure 13
Final OPG of case 1.
Figure 14
Figure 14
Initial intra-oral composite photograph of case 2.
Figure 15
Figure 15
Initial study model of case 2.
Figure 16
Figure 16
Initial cephalogram of case 2.
Figure 17
Figure 17
Initial OPG of case 2.
Figure 18
Figure 18
Final intraoral composite photograph of case 2.
Figure 19
Figure 19
Final study model of case 2.
Figure 20
Figure 20
Final cephalogram of case 2.
Figure 21
Figure 21
Final OPG of case 2.

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