Class II subdivision with skeletal transverse maxillary deficit treated by single-sitting bone-borne appliance

Angle Orthod. 2021 Jan 1;91(1):129-137. doi: 10.2319/050520-394.1.


This case report describes orthodontic treatment including both skeletal maxillary expansion and unilateral distalization by means of a single bone-borne appliance followed by clear aligner therapy in a young adult patient. A surgical guide was digitally designed and three-dimensionally printed to facilitate the placement of four miniscrews in the palatal vault. The miniscrews were fitted and the bone-borne appliance was delivered in a single clinical appointment. The postexpansion photographic records and models demonstrate the opening of the palatal median suture, the pure skeletal expansion, and the resolution of the left crossbite after 40 activations. Specifically, left molar Class I was obtained in about 5 months without any loss of anterior anchorage, and the subsequent aligner phase achieved all of the objectives established in the treatment plan. This case report shows clearly how careful digital planning of miniscrew insertion and the delivery of a pure bone-borne appliance in a single sitting enabled good clinical outcomes to be achieved in an acceptable timeframe, without side effects, even in a young adult patient.

Keywords: Aligners; Class II subdivision; Distalizing intraoral appliance; Miniscrew; Rapid palatal expander.

Publication types

  • Case Reports

MeSH terms

  • Bone Screws
  • Cephalometry
  • Humans
  • Maxilla / diagnostic imaging
  • Orthodontic Anchorage Procedures*
  • Orthodontic Appliance Design
  • Palatal Expansion Technique
  • Sitting Position*
  • Tooth Movement Techniques
  • Young Adult