Combining Circumvestibular Corticotomy with Maxillary Protraction as a Conservative Approach to Treatment in an Adolescent with Maxillary Deficiency: A Case Report with Long Term Follow-up

Farzad Piroozmand; Mohsen Shirazi; Behzad Salari; Hooman Zarnegar

doi:10.18502/fid.v19i28.10599

Farzad Piroozmand Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Mohsen Shirazi Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Behzad Salari Department of Orthodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
Hooman Zarnegar Private Practice, Tehran, Iran

DOI: https://doi.org/10.18502/fid.v19i28.10599

Keywords: Malocclusion, Angle Class III; Maxilla; Retrognathia; Orthopedic; Adolescent; Activator Appliances

Abstract

Maxillary protraction with a face mask is an effective treatment for class III children with maxillary hypoplasia. However, in late adolescence, orthopedic approaches are not very effective for treatment of maxillary deficiency. The aim of this study was to report a minimally invasive technique to orthopedically treat a 16-year-old female adolescent with mild to moderate maxillary deficiency, before the cessation of growth. A circumvestibular corticotomy technique was performed followed by a regimen of rapid maxillary expansion and application of heavy extra-oral forces. After termination of the orthopedic and orthodontic phases, the patient was monitored for ten years. The dental and skeletal results immediately after treatment were compared with the results ten years after termination of treatment. A noticeable anterior displacement of “A” point was observed after the orthopedic phase and this remained unchanged for ten years.