MSE Arch Expansion in Your 30s: Non-Extraction Clippy-C Treatment for Crowding and Crossbite, and Side Effects

Hello.

This is Apgujeong Orthodontic Clinic.

If crowding is severe but there is no lip protrusion, we proceed with non-extraction orthodontic treatment. Usually, wisdom teeth are extracted, and the space from the wisdom teeth is used to move the molars backward so the front teeth can be aligned. However, there are cases where there is no wisdom tooth space.

In such cases, an arch expansion device may be used to align crowded teeth without extraction. In today’s post, I will show a case in which severe crowding was resolved without extraction in an adult in their late 30s using an arch expansion device.

I will also introduce the changes that occur when the palatal bone is separated with an MSE arch expansion device.

MSE Arch Expansion in Your 30s: Non-Extraction Clippy-C Treatment for Crowding and Crossbite, and Side Effects

24.07

There is crowding, and the upper and lower dental midlines are misaligned.

The reason the dental midlines are misaligned is because of mandibular asymmetry.

In comparison, the posterior molar occlusion is relatively good.

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Considering the patient’s thin lips and lip line, extraction treatment involving the premolars would not be a good option, so we decided on non-extraction treatment.

However, since there is no wisdom tooth space, a non-extraction posterior movement method is difficult to use.

Therefore, we decided to resolve the crowding through maxillary arch expansion.

Considering the patient’s age in the late 30s and sex, the likelihood of arch expansion failure was high, so on the day the arch expansion device was placed, corticopuncture was also performed along the suture line to loosen the bone.

In October 2024, the arch expansion was successful, and the spaces between the front teeth opened up.

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When the front teeth separate like this, that is a good sign.

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The arch expansion device is kept in place for about 6 months so that hard bone can fill back into the separated suture.

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Meanwhile, brackets were first attached to the upper teeth to begin alignment.

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Two months later, brackets were also attached to the lower teeth to begin full-scale orthodontic treatment.

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As treatment continued, an orthodontic mini-screw was also placed in the lower jaw to correct the midline deviation caused by mandibular asymmetry.

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And finally, treatment was completed.

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The midline is nearly aligned now.

The occlusion shows a tight Class I relationship.

Let’s look at the before-and-after comparison.

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Including the arch expansion period, the total treatment time was 1 year and 3 months.

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Improvement in the midline and resolution of crowding

Now let’s look at the facial comparison.

When arch expansion is performed, the distance between the two sides of the nostrils widens slightly.

In other words, the width of the nose increases.

People with rhinitis often say breathing becomes much easier and more comfortable.

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As you can barely see in the photo, there is almost no sense that the nostrils became wider.

Some people hesitate to undergo arch expansion because they worry their nose will widen, but the conclusion is that it is not noticeable..

Recently, another patient said that people around them kept telling them they looked better and more refreshed.

24.07~25.10

It has been a long time since I last heard the phrase “looking refreshed.”

Rather than saying “you got prettier,” it is a better expression for a brighter, improved overall impression.

Looking at this patient’s smile in the before-and-after comparison, they also seem much more refreshed.

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This patient has a very nice nose.

This is not an orthodontic treatment that changes the lip line.

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After treatment, there was no root resorption, and the root alignment is also good.

I hope this post is helpful for people who need orthodontic treatment because of crowding but are afraid of extractions.