Initial situation
- 16-year-old female patient
- Crowding in both upper and lower arches
- Crossbite in the area of the lateral incisor
- Misaligned canine, the patient's main aesthetic concern
- Initial skeletal Class III (mesial bite)
The decision
The treatment plan used the Damon Q2 bracket system for controlled, gentle expansion, combined with bite turbos and early light Class III elastics to manage the skeletal Class III relationship, crowding, and crossbite.
Controlled transverse expansion combined with early Class III elastics can address both the crossbite and the skeletal discrepancy in growing patients.
The result
Total active treatment time was about 18 months. At 5-year follow-up, the result remains stable, functional, and esthetically pleasing.
In growing patients with a skeletal Class III tendency and crossbite, combining controlled expansion, bite turbos, and early Class III elastics can produce a stable long-term result.
About skeletal expansion & MARPE
A skeletal Class III tendency combined with a lateral crossbite and crowding calls for a plan that manages the transverse and sagittal problems together, since expansion mechanics and Class III elastics interact. Bite turbos support disocclusion during early elastic wear, while controlled expansion addresses the crossbite without excessive dental tipping. This case illustrates the value of coordinated transverse and sagittal management in a growing patient with a developing skeletal discrepancy.
Questions clinicians ask
What made this a skeletal Class III case?
The patient presented with an initial mesial bite, classified as a skeletal Class III relationship, alongside crossbite and crowding.
Why were bite turbos and Class III elastics used?
Bite turbos and early light Class III elastics were used as part of controlled expansion to manage the crossbite and the Class III relationship together.
How stable was the result at follow-up?
At five years after treatment, the result remains stable, functional, and beautiful.
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Original case shared by Dr. Mark Radzhabov on Instagram @orthodont_mark · Published for professional education.
