An adult case of skeletal open bite with a severely narrowed maxillary dental arch

Surgically assisted rapid maxillary expansion is proposed as an efficient approach for adult patients with transverse maxillary deficiency. This article reports the treatment of an 18-year, seven-month old male patient with an anterior open bite and a severely narrowed upper dental arch. A posterior crossbite was present on both sides. For the correction of the posterior crossbite, a lateral maxillary expansion of more than 8 mm was required. A surgically assisted rapid maxillary expansion with Le Fort I corticotomy and mandibular setback with a sagittal splitting ramus osteotomy were determined as the treatment plan. The total treatment time was 24 months including five months of post-surgical observation. After the treatment, an acceptable occlusion was achieved with a Class I molar relationship. The amount of actual maxillary expansion was 6.3 mm at the canines and 9.7 mm at the first molars. The relapse of the expansion was 0.9 mm and 0.1 mm at the corresponding regions two years after the surgically assisted maxillary expansion. It is emphasized that surgically assisted rapid maxillary expansion is a secure and efficient approach for achieving a desirable lateral maxillary expansion with stability in adult patients demonstrating transverse maxillary deficiency. Furthermore, it is suggested that longterm observation of the maxillary arch width after retention is of a great importance for the maintenance of the acceptable treatment outcome.