RESTORATION OF FACIAL HARMONY

INITIAL SITUATION

The 7-year-old patient presents with a narrow palate and a right lateral crossbite.

On the side of the mouth with the crossbite, the upper teeth close inside relative to the lower teeth, whereas normally the upper teeth should be positioned outside the lower teeth. When the palate is narrow, the mandible often cannot close properly with the upper jaw, causing it to shift to one side in order to make the teeth contact. In this case, the lower part of the face may also appear shifted towards the side of the crossbite.

OBJECTIVE

The goal of the orthodontic treatment is to widen the palate to restore its correct transverse dimension, allowing the mandible to close symmetrically without shifting to one side. Correcting this interference helps restore harmonious facial growth, preventing the face from growing asymmetrically. Early treatment of the crossbite (around 6-8 years old) is highly recommended, as the palate is still soft (the palatal suture is still open), making the correction easier and more effective.

TREATMENT

The therapy involves palatal expansion. There are several methods to achieve this, but in our opinion, the most effective is the use of a rapid palatal expander.

The expander is a fixed device that is glued to the teeth and acts on the bones, allowing for a lasting normalization of the palate width and symmetric closure of the mandible and teeth. Contrary to what one might think, this is a painless procedure that works by stimulating the natural biological process of bone growth at the suture level. The expander is highly tolerated by children, who usually adjust to the presence of the appliance within a few days.

MEDICAL CONSIDERATIONS

Rapid palatal expansion is a method that is:

• Effective: It directly addresses the problem (the bone size) and does not merely incline the teeth outward (unlike removable appliances).

• Highly predictable: Since it is a fixed appliance, the outcome is not dependent on the child’s cooperation.

• Fast: The treatment duration is relatively short, with results achieved in about 2 months, followed by 8 months of stabilization.

After the expansion treatment, our young patient now has a palate of correct dimensions. The crossbite has been corrected, and all the upper teeth are now positioned outside the lower teeth. The mandible can now close symmetrically, and the center of the upper teeth now aligns with the center of the lower teeth. The patient now has a wide smile, and facial harmony has been restored.