Anterior Maxillary Expansion using Modified Reverse Quad Helix Appliance in Cleft Palate Patient
Background: Non-surgical orthodontic expansion in an operated cleft lip and palate is an effective non-invasive treatment approach in an adult patient. Case report: This case report introduces a new approach of maxillary expansion for treating a severe maxillary transverse discrepancy in a skeletally mature patient. This approach uses a modification of quad-helix expander with reverse action to achieve expansion in the anterior maxillary region. An 18-year-old girl presented with a severe maxillary transverse discrepancy, straight profile, severe maxillary crowding and a Class III skeletal relationship. The treatment protocol consisted of maxillary expansion and active orthodontic therapy during the initial phase of treatment. A pre-activated Reverse quad helix expander was fitted; after the desired expansion was achieved, active orthodontic therapy was started. The treatment duration was 12 months 2 weeks. The good arch form was achieved after the initial phase of the treatment. Conclusion: This approach is a good alternative for treating a severe maxillary transverse discrepancy in a skeletally mature cleft palate patient and gain anterior expansion, which is more often desired in cleft palate patients and especially for a patient who does not want surgically assisted rapid palatal expansion.