Maxillary deficiency treatment by fixed tongue appliance--a case report

This case illustrates orthopaedic treatment of a 12.1-year-old girl with class III malocclusion and maxillary deficiency. The patient was treated by a fixed tongue appliance in the upper jaw. First maxillary molars and premolars were banded and a hyrax was mounted on them in order to achieve lateral expansion. A fixed tongue appliance comprising of a few cribs was soldered to the anterior side of the hyrax with the purpose of pushing the maxilla in forward position. The orthopaedic stage of treatment lasted for 5 months after which favourable correction of the malocclusion was observed. The SNA angle increased by 2 degrees, the IMPA decreased by 10 degrees and mandibular plane angle (GoGn-SN) increased by 20. After this time, the fixed tongue appliance and Hyrax remained in the mouth for 3 more months as retention. This case demonstrates that fixed tongue appliance might be an alternative method to extra oral appliances in class III and maxillary deficient cases.