Application of Combined Maxillary Skeletal Expander and Facemask Treatment with an Alternating Rapid Maxillary Expansion and Constriction Protocol in a Female Adolescent with a Class III Skeletal Relationship

A 13-year-old female patient presented with a chief complaint of anterior crossbite and chin prognathism.She had a skeletal Class III relationship with a brachyfacial vertical pattern. Anterior crossbite exhibitedmaximum intercuspation–centric relation shift, leading to an edge-to-edge incisal position. On the basis of thispatient’s chronological age, it was too late to perform conventional early treatment of Class III cases, whichincludes rapid palatal expansion combined with facemask or chincap therapy. After discussing treatmentoptions with the patient and her parents, we decided to try combined maxillary skeletal expander and facemasktreatment with an alternating rapid maxillary expansion and constriction protocol to facilitate mid-faceprotraction. After anterior crossbite correction, an upper 2 × 6 appliance was used for anterior teeth alignment.Active treatment time was 14 months and the patient achieved considerable maxillary traction as well as profilechange. The patient and her parents were satisfied with the treatment result although the uncertain residualmandibular growth requires ongoing monitoring. (Taiwanese Journal of Orthodontics. 30(1): 43-55,2018).