Rapid maxillary expansion in a pediatric patient with exocrine pancreatic insufficiency

Exocrine pancreatic insufficiency is a condition capable of promoting changes in craniofacial growth and development. This case report describes treatment of a 9-year-old patient with chronic pancreatic insufficiency, highlighting the diagnostic aspects involved and clinical implications of this condition with respect to dental treatment. The treatment plan involved oral hygiene recommendations and correction of bilateral posterior crossbite and anterior open bite. Just 2 weeks after orthodontic treatment, the corrected dentition relapsed completely, confirming the difficulty of promoting ossification in the median palatine suture. Orthodontists should be careful to develop an individualized treatment plan for each patient with this abnormality, because these determinations could mean the difference between success and failure of the treatment approach.