Complex orthodontic and surgical management of an adult patient with transverse maxillary deficiency and skeletal class III malocclusion: A case report.

Skeletal deformities constitute a relatively common structural and functional craniofacial abnormality. The chief complaints reported by patients include a lack of satisfaction with facial appearance, difficulty with breathing or eating, and altered speech. The management of skeletal malocclusion requires a complex orthodontic and surgical approach. The paper presents the case of a 28-year-old woman with maxillary constriction and skeletal class III malocclusion. Transpalatal distraction (TPD), based on the distraction osteogenesis phenomenon, was used for correcting transverse maxillary deficiency by increasing the maxillary bone base, and therefore the transverse maxillary dimension. The next stage was orthodontic treatment, involving dentoalveolar decompensation, as part of preparation for bimaxillary osteotomy (BIMAX). The last stage of the complex treatment was BIMAX, which ultimately eliminated skeletal defects in both the sagittal and frontal planes. This complex multidisciplinary management significantly improved facial harmony, increased nasal volume, caused a shift from mouth breathing to nasal breathing, and restored normal occlusal relationships.