성인 편측성 구순구개열 환자에서 비수술적 상악 확장후 순측 호선에 의한 장기간 폭경 유지 증례

Abstract

Purpose: We report a case of an adult patient with skeletal Class II hyperdivergent and complete unilateral cleft lip and palate (UCLP, left side), whose severe transverse discrepancy was successfully resolved via nonsurgical maxillary expansion followed by unintentional long-term maintenance with buccal archwire. Case: A 26-year-old female patient with skeletal Class II hyperdivergent and complete UCLP showed maxillary constriction with bilateral posterior crossbite. To solve transverse discrepancy mainly in the posterior area, nonsurgical rapid palatal expansion was attempted twice. During comprehensive orthodontic treatment, treatment was discontinued for 10 years and 1 month in total due to inadvertent absence of the patient. Meanwhile, buccal archwire was retained without bone graft. After extraction of the maxillary right first premolar and the mandibular both first premolars, space closure was conducted to complete the treatment at Class I molar relation. After orthodontic treatment, the intermolar width between the maxillary first right and left molars was increased by 10.5 mm and acceptable transverse relationship was achieved. Conclusion: Nonsurgical maxillary expansion with long-term transverse control may be effective for severe maxillary constriction in an adult patient with UCLP. Bone graft does not appear to be essential for the stability.