Severe Adult Orthodontic Malocclusion & Airway issues Part 2

266 Rating(s).


Posted on By Maurice Salama In Orthodontics

Thoughts on treatment for this Adult Male with Severe Skeletal and Dental Malocclusion. Has medical issues as well and sleep apnea/airway concerns. Missing maxillary central incisor, severe crowding, maxillary constriction, V-shaped arch form, etc. etc. Thoughts? Treatment plans? Dr. Salama

SARPE Sx Assisted Rapid Palatal Expansion
RPE Expansion

Maxilla after Invisalign & RPE
Mandible after Invisalign


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13 Comments

Pre and Post images

Preop ortho
Post op SARPE & Invisalign


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Pre and Post images

Preop ortho
Post op SARPE & Invisalign


Reply

Pre and Post images

Preop ortho
Post op Invisalign


Reply

Pre and Post images

Preop Face
post op Face


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You must have a happy patient !! It would be interesting to find out how much his apnea score improved from just that expansion and the tongue room it provides.


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Laurent; He has lost significant weight and his Apnea Scores are now down to levels where it may become manageable without a CPAP and just dental orthotic device. Thanks Dr. Salama


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Beautiful outcome Mo!
Did you ever tried to adress this type of cases using 4 manipulates as skeletal anchors?
It's very useful as you can expand a lot and at the same time you can distalise the posterior groups ( from canine to second molar).
Once again, awesome outcome! Congrats!
Bernardo


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Bernardo; No, I never have. Can you post such a case here? Thanks Mo


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great job! so you did end up extracting a lower incisor for crowding


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Yes I did...


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Just love this. Beautiful management.
Thanks for sharing Dr Salama,
Wha


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Amazing result would love to see( and learn) a little more about the process of the surgical patal expansion. I was under the impression that u have to 'open' the mid line suture in order to gain expansion in adults with a process similar to bone-distraction and here it seems you focused on vestibule instead. Great result kudos for sharing Aryeh


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No actually, the midline palatal suture is opened via chisel placed from the Anterior ANS. Thanks for your comment. SARPE Surgically assisted rapid palatal expansion requires cuts made in the Vestibule, Maxillary Lateral walls (Surgical burs), Mid palatal suture line (Chisels), and Pterygoid plates (Chisels). This procedure was performed in-office under IV sedation by our OMFS Dr. Abtin Shariari. Thnx Dr. Salama


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