미니스크류 지지형 상악 구개 급속 확장과 하악 전 치열 원심 이동을 동반한 골격성 III급 절충 치료

Skeletal Class III Camouflage Treatment Using Miniscrew-Assisted Rapid Palatal Expansion and Total Distalization of the Mandibular Dentition

Miniscrew-assisted rapid palatal expansion (MARPE) is a non-surgical modality that enables maxillary skeletal expansion in skeletally mature patients, thereby eliminating the need for invasive surgical procedures. Beyond addressing transverse maxillary deficiency, MARPE has demonstrated the ability to induce skeletal displacement of the maxilla, contributing to the correction of sagittal discrepancies in Class III malocclusion. When combined with total mandibular arch distalization using skeletal anchorage, this approach broadens the scope of orthodontic camouflage offering a clinically meaningful alternative to orthognathic surgery in borderline cases. A 21-year-old female presented to the orthodontic department with a chief complaint of an edge-to-edge bite. Her pervious orthodontic camouflage treatment for Class III malocclusion involved extraction of four premolars. Clinical evaluation revealed transverse maxillary deficiency, a left posterior crossbite, and compensatory inclinations of both anterior and posterior teeth. MARPE was employed to achieve maxillary skeletal expansion, while miniscrews were strategically placed in the retromolar pad area to facilitate total mandibular arch distalization. The overall treatment period was 10 months. MARPE successfully corrected the transverse skeletal discrepancy and induced a downward displacement of the maxilla accompanied by clockwise rotation. Mandibular dentition was distalized without significant tipping of the second molars or rotation of the occlusal plane, underscoring the biomechanical stability of the approach.