In some cases, with mild or moderate skeletal Class III malocclusion and maxillary arch deficiency, surgically assisted rapid maxillary expansion (SARME) can be considered. Previously, a similar case of a 20-year-old woman was reported by Rizatto, et al, with mild Class III skeletal pattern, vertical growth pattern, maxillary arch deficiency, and moderate maxillary crowding with ectopic right canine, was treated by SARME followed by Facemask, RME, and standard edgewise technique. These treatments had improved patient’s, facial profile attributed to the extrusion and proclination of the maxillary anterior teeth (U1-NA: 2 mm).16 Compared with this present case, facial profile improvement was also attributed to the proclination of maxillary anterior teeth (U1-NA: 5 mm), without invasive treatment.
Other similar cases reported by Yang et al, Zhang et al, and Sabri et.al, showed the treatment success of 11-13 year-old patients with moderate Class III skeletal pattern, vertical growth pattern, maxillary arch deficiency, and severe maxillary crowding with ectopic canines, treated by Facemask and rapid maxillary expansion (RME) followed by conventional ligated system and other auxiliary appliances for 35-47 months.C A combination of Facemask and RME has been recommended to correct skeletal Class III malocclusion with maxillary arch deficiency and fairly normal mandible, particularly in growing patient. The combined orthopedic effects of these appliances would bring the maxilla downward and forward, in conjunction with clockwise rotation of the mandible to improve patient’s profile and smile aesthetic, while in some cases would cause maxillary incisors proclination. Those effects would increase ANB angle (0°- 4.5°) and U1-NA (0.4 mm – 8 mm) in those similar cases, as well as in this present case (ANB angle: 1°, U1-NA: 5 mm), thus improveing patient’s facial profile and dental occlusion.
This present camouflage treatment, using PSL-system, had given satisfying results without any additional maxillary arch expander and other auxiliary appliances in a relatively shorter treatment duration (26 months), compared with similar previous cases (35-38 months). The combination of Facemask, RME, and conventional ligated system relied on patient cooperation and required long-term stability, so it may brequire increased treatment duration. In addition to this, relatively shorter treatment duration of this present case was probably due to