Surgically-assisted rapid palatal expansion and orthodontic treatment in preparation for Le Fort I and sagittal split osteotomy surgery

This article reports the treatment of a 15-year old male patient with anterior open bite and a severely narrowed upper dental arch. The young patient complained of occlusal and masticatory dysfunction due to the anterior open bite and difficulties in breathing normally through his nose. A posterior crossbite was present on both sides. For the correction of the posterior cross-bite, a surgically assisted rapid maxillary expansion and a presurgical straight wire multibracket tooth alignment was applied. The treatment plan included Le Fort I osteotomy and mandibular setback with a sagittal splitting ramus osteotomy. The total treatment time was 36 months, including five months of post-surgical observation. After treatment, a stable occlusion was achieved with a Class I molar relationship and a complete open-bite closure. The patient referred remarkable improvements in breathing. Surgically assisted rapid maxillary expansion and Le Fort 1 osteotomy can be regarded as a safe and effective approach for the treatment of skeletal divergence. Long-term observation of the maxillary arch width after retention is of the utmost importance for the maintenance of a successful treatment outcome.