Initial: This patient has a posterior crossbite and anterior cross bite. The patient also had a poor nasal airway. From an orthodontics perspective this is typically treated with Phase I that includes upper and lower expansion and sometimes a facemask, with a possible Phase II treatment to follow.

Treatment: Phase I expansion was planned in order to make room for the adult teeth to come in and correct the bite relationship as well as widen the floor of the nose to promote better nasal breathing. In this case a Phase II treatment was also intended following Phase I however it was not needed. In order to make room and widen the upper jaw a hyrax and ortho brackets were placed on a few upper teeth. To widen the lower a schwartz was placed.

Final: This patient has a beautiful smile without the need of a facemask or Phase II treatment. The patient’s profile and smile were dramatically impacted. Nasal airway was also resolved leaving the patient with proper function and form.