Surgically assisted palatal expansion: an important consideration in adult treatment

An increasing percentage of orthodontic patients are adults with challenging malocclusions. While some aspects of many adult cases are similar to those seen in children, others must be addressed quite differently. Although many adults appear to be generally more cooperative than children in dealing with the inconveniences of orthodontic treatment, they nonetheless require efficient, less lengthy treatment plans. Many are intolerant of multiple extractions or elaborate surgery. Consequently, the need for practical treatment plans that assure good, stable results is real. Also, any perceived change in the soft tissue profile (positive or negative) is likely to be significant to the patient. The case presented here, in which surgically assisted palatal expansion and extraction of one mandibular incisor were employed, illustrates an approach to a difficult adult orthodontic problem that is both practical and efficient from diagnostic and biomechanical points of view. In this case, in which an adult patient exhibited significant transverse discrepancies and dental crowding, a treatment plan that addressed these considerations was employed.