Compensatory orthodontic treatment for maxillary deficiency: A 4-year follow-up

•Transverse deficiencies during growth are best solved with rapid maxillary expansion (RME).•Forces generated by Class III elastics are similar to forces generated by reverse traction or chincup.•Cooperation with class III elastics is better and longer than with reverse traction or chincup.•Time to stop class III treatment should be when growth ends, increasing treatment time.•Correction of anterior crossbites does not require any kind of retention for stable results.

In this article, we report the orthodontic treatment of a boy (age 12 years 9 months) who had a midface deficiency, a concave facial profile with maxillary retrusion, a complete crossbite (anterior and posterior), and the maxillary right canine retained in the alveolus. Rapid maxillary expansion was performed followed by complete orthodontic treatment with fixed appliances combined with Class III elastics and anterior vertical elastics. Time was allowed to elapse until growth was virtually over before removing the fixed appliances (at age 18 years 4 months), and no retainer of any type was used. As a result of treatment, significant improvement was noted in his facial appearance, with a proper maxillomandibular relationship, total correction of the maxillary atresia, and satisfactory overjet and overbite. The results remained stable at the 4-year follow-up. Therefore, it can be argued that the use of Class III elastics combined with rapid maxillary expansion has a beneficial effect in the treatment of transverse and sagittal maxillary deficiency in growing patients. Excellence in how the treatment was finished and discontinuation of treatment and control in the final stages of growth contributed to the stability of the final results.