Nonextraction treatment of a skeletal Class III adolescent girl with expansion and facemask: Long-term stability

• A maxillary protraction facemask was effective after the patient's peak of pubertal growth spurt.
• Midpalatal suture opening with rapid maxillary expansion enhanced the orthopedic effect of the facemask and vice versa.
• Combined rapid maxillary expansion and facemask effects optimized anterior tooth display and reduction of lateral negative spaces.
• Individual dentofacial characteristics may allow clinicians to push the envelope of treatment beyond central tendencies.

This article describes the combined use of maxillary expansion and a protraction facemask in the correction of a skeletal Class III malocclusion after the patient's pubertal growth spurt. Treatment efficacy and the effects on facial and smile esthetics are presented. The nonextraction option with an arch-size increase and stability issues is discussed.