Initial situation
- Mesial occlusion
- Anterior crossbite
The decision
MARPE was combined with a facial mask to treat the mesial occlusion and anterior crossbite. This approach was selected to achieve maximum skeletal movement rather than relying primarily on dental tooth movement, which increases the long-term stability of the result. The patient continues to be monitored through ongoing growth.
Prioritizing skeletal movement over dental compensation increases the long-term stability of Class III correction.
The result
Combining MARPE with a facial mask produced skeletal correction of the mesial occlusion and anterior crossbite. The patient remains under continued monitoring as growth progresses.
In growing patients with mesial occlusion and anterior crossbite, combining MARPE with a facial mask can prioritize skeletal correction for a more stable long-term outcome.
About skeletal expansion & MARPE
Mesial occlusion paired with anterior crossbite in a growing patient points to a skeletal, not purely dental, origin of the malocclusion. In cases like this, clinicians typically evaluate maxillary skeletal deficiency and transverse dimension before committing to an appliance strategy, since achieving skeletal movement rather than dental compensation improves long-term stability. MARPE combined with a facial mask reflects this diagnostic priority, targeting the growth-related skeletal discrepancy directly rather than masking it with tooth movement alone.
Questions clinicians ask
Why was MARPE combined with a facial mask in this case?
The combination was chosen to achieve skeletal movement of the maxilla rather than relying only on tooth movement, improving long-term stability of the crossbite and Class III correction.
Is this treatment approach specific to growing patients?
Facial mask therapy relies on remaining growth potential, so the patient in this case continues to be monitored as growth progresses.
What is the clinical advantage of skeletal over dental correction?
Skeletal movement addresses the underlying discrepancy directly, which tends to produce a more stable result than compensating through dental tipping alone.
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Original case shared by Dr. Mark Radzhabov on Instagram @orthodont_mark · Published for professional education.
