Korean J Orthod.  2022 Sep;52(5):372-382. 10.4041/kjod22.158.

Clinical application of maxillary tissue bone-borne expander and biocreative reverse curve system in the orthodontic retreatment of severe anterior open bite with transverse discrepancy: A case report

• Choi JY
• Jin B
• Kim SH

• KMID: 2533262
• DOI: http://doi.org/10.4041/kjod22.158

Abstract

Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.

Keyword

Miniplate; Expansion; Relapse; Class II

Figure

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  Figure 1 Pretreatment facial and intraoral photographs.

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  Figure 2 Pretreatment panoramic radiograph and lateral cephalometric radiograph.

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  Figure 3 Diagram explaining the treatment plan. Black arrows indicate the direction of tooth movement. A, Transverse palatal expansion by C-expander. Lateral movement of the posterior teeth was planned with the bony expansion. B, Simultaneous palatal and buccal intrusion using miniscrews of the C-expander and buccal C-tube miniplate. C, Molar uprighting by biocreative reverse curve system using C-tube miniplate at the symphyseal area, and total intrusive retraction of the maxillary dentition by buccal C-tube miniplate. Uprighting moments would occur in the posterior teeth by lifting the reverse curve nickel-titanium archwire upward at the symphyseal region.

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  Figure 4 Application of the biocreative reverse curve system on the mandibular posterior teeth.

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  Figure 5 Procedure of the C-expander placement.

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  Figure 6 Treatment progress using the C-expander and biocreative reverse curve system.

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  Figure 7 Cone beam computed tomography images before and after palatal expansion with C-expander.

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  Figure 8 Treatment progress after removing the resin part of the C-expander and bonding brackets on the maxillary dentition.

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  Figure 9 Finishing and detailing stage after removing the C-tube miniplate and bonding brackets on the mandibular dentition.

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  Figure 10 Posttreatment facial and intraoral photographs.

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  Figure 11 Posttreatment panoramic radiograph and lateral cephalometric radiograph.

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  Figure 12 Superimposition between pretreatment and posttreatment cephalometric radiographs.

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  Figure 13 Lateral facial photo and cephalometric radiograph after advancement genioplasty.

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  Figure 14 Intraoral photographs taken at 4-year follow-up.

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