Maxillary sagittal expansion in an adult patient

Relevance . Skeletal Class III malocclusion is known to be one of the most difficult malocclusions to correct. Nonsurgical treatment of Class III in adults is a challenge; however, this patient refused surgery. A treatment method with Fixed Anterior Growth Guidance Appliance (FAGGA) was investigated in the study. Materials and methods . This case report presents a 37-year-old woman with skeletal Class III malocclusion for maxillary deficiency. As the patient didn’t agree to surgery, she was treated by Fixed Anterior Growth Guidance Appliance, followed by 3D SMILE® clear aligners. Fixed Anterior Growth Guidance Appliance was used initially. After 4 months, the appliance was removed and clear aligner treatment was initiated. Post-treatment radiographs showed improvement. Results . Intraorally, in the upper arch, a total of 4.00 mm of space were gained (about 2.00mm distal to each canine). The post-treatment cephalometric analysis showed a skeletal A-P Class I, the Upper incisor inclination to the optic plane was not significantly altered, ANS — antArc was improved by 1.5mm, the Effective Length of the Premaxilla increased by 2.6mm, U1 — ANS’ decreased by 1.7mm, Incisor mandibular plane angle (IMPA) autonomously improved by 11 degrees. Conclusions . Maxillary deficiency was corrected successfully with the Fixed Anterior Growth Guidance Appliance. The treatment is being continued by 3D SMILE® clear aligners. The goal was achieved despite the patient’s age and nonsurgical treatment.