Incorporation of Invisalign system with different maxillary expansion principles and protocols in adult patients: a case series
摘要
Transverse discrepancies affecting the maxillary arch are one of the most common orthodontic problems faced by orthodontists. In children, a narrow maxilla can be easily treated by dentoalveolar or skeletal expansion, depending on the type and severity of the constriction, while in young and adult patients, it is critical to evaluate the possibility of performing expansion before initiating the treatment. A comprehensive diagnosis is crucial for determining the appropriate treatment for maxillary constriction. The expansion process can be either slow or rapid, with each method utilizing different forces to achieve the desired results. Slow maxillary expansion involves applying constant, light pressure, whereas rapid expansion requires heavier forces. When the midpalatal suture is fused, surgically assisted rapid maxillary expansion is often the preferred treatment. The use of clear aligners to treat complex cases, including maxillary constriction, has become more common. This case series aims to demonstrate how the integration of different skeletal expansion approaches with clear aligner therapy can be strategically applied to manage maxillary transverse deficiency in adult patients, as illustrated in three clinical cases, thereby enhancing treatment outcomes and overcoming the limitations of clear aligner-only therapy. The first case was treated using clear aligner therapy following miniscrew-assisted slow palatal expansion. The second and third cases included using Invisalign aligners after performing surgically assisted rapid palatal expansion and surgical expansion. All three cases resulted in the planned orthodontic outcomes due to precise diagnosis and evaluation. Additionally, selecting the appropriate expander type and location and following the correct activation protocol were crucial to the success of the expansion.