Treatment of a severe transverse dental arch discrepancy assisted by 3-dimensional planning

This report describes the treatment of a 16-year-old girl with a severe transverse dental arch discrepancy resulting from a mildly constricted maxillary arch and an overexpanded mandibular arch. The patient had a Class I skeletal relationship, a high mandibular plane angle, a Class III molar relationship, bilateral posterior crossbites, and deviated midlines. A 3-dimensional digital setup was used to assist treatment planning. The digital setup allowed us to evaluate multiple treatment options before deciding on the most suitable one for the patient. The final treatment protocol consisted of extraction of upper second premolars and lower first molars due to enamel hypoplasia. Starting with the leveling and alignment stage of treatment, the maxillary archwires were expanded and the mandibular wires were constricted to correct the transverse discrepancy. An auxiliary expansion arch was used to achieve overcorrection. The active treatment period was 24 months. Proper overbite and overjet, facial balance, and good occlusion were achieved.