{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:23:58Z","timestamp":1790123038397,"version":"4.0.1"},"reference-count":88,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This case report describes the use of a miniscrew-assisted rapid palatal expander and aligners to correct bilateral cross-bite and crowding in an adult patient with a Class III skeletal pattern. A digitally designed surgical guide was three-dimensionally printed and used to accurately insert four miniscrews into the palate; these were employed to anchor a novel miniscrew-assisted rapid palatal expander appliance without any dental anchorage. Cone-beam computed tomograms before and after miniscrew-assisted rapid palatal expander treatment demonstrated the orthopedic expansion of the maxilla without dental tipping. The patient was then fitted with aligners to correct crowding and malocclusion. This case report demonstrates the successful treatment of an adult patient with a narrow maxilla and bilateral cross-bite using a nonsurgical, conservative treatment.<\/jats:p>","DOI":"10.2319\/111617-790.1","type":"journal-article","created":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T08:24:57Z","timestamp":1525163097000},"page":"649-664","source":"Crossref","is-referenced-by-count":26,"title":["Class III malocclusion and bilateral cross-bite in an adult patient treated with miniscrew-assisted rapid palatal expander and aligners"],"prefix":"10.2319","volume":"88","author":[{"given":"Luca","family":"Lombardo","sequence":"first","affiliation":[{"name":"Research Assistant, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Carlucci","sequence":"additional","affiliation":[{"name":"Research Fellow, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bortolo Giuliano","family":"Maino","sequence":"additional","affiliation":[{"name":"Visiting Professor, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Colonna","sequence":"additional","affiliation":[{"name":"Research Fellow, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Paoletto","sequence":"additional","affiliation":[{"name":"Orthodontic Technician, Lab Orthomodul, Thiene, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Siciliani","sequence":"additional","affiliation":[{"name":"Professor and Chairman, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-88-5-649-b01","series-title":"J Dent Res","first-page":"706","article-title":"Prevalence and distribution of selected occlusal characteristics in the US population, 1988-1991","volume":"75","author":"Brunelle \n              JA,","year":"1996","unstructured":"Brunelle \n              JA, \n            \n            \n              Bhat \n              M, \n            \n            \n              Lipton \n              JA. \n            \n          \n          Prevalence and distribution of selected occlusal characteristics in the US population, 1988-1991. 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Dental Press J Orthod. 2013;18:12\u201328."},{"key":"i0003-3219-88-5-649-b10","series-title":"Ci\u00eancia e Odontologia casos cl\u00ednicos baseado em evid\u00eancias cient\u00edfica","first-page":"232","article-title":"Uma nova alternativa para a expans\u00e3o r\u00e1pida da maxila assistida por mini-implantes usada para a corre\u00e7\u00e3o ortop\u00e9dica em paciente Classe III esquel\u00e9tica em crescimento","author":"Curado \n              MM,","year":"2015","unstructured":"Curado \n              MM, \n            \n            \n              Suzuki \n              SS, \n            \n            \n              Suzuki \n              H, \n            \n            \n              Garcez \n              AS. \n            \n          \n          Uma nova alternativa para a expans\u00e3o r\u00e1pida da maxila assistida por mini-implantes usada para a corre\u00e7\u00e3o ortop\u00e9dica em paciente Classe III esquel\u00e9tica em crescimento. In: Junqueira JLC, Napimoga MH, eds. 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Campinas: Mundi Brasil;2015:232\u2013237."},{"key":"i0003-3219-88-5-649-b11","series-title":"Rev Cl\u00edn Ortod Dental Press","first-page":"110","article-title":"Expans\u00e3o r\u00e1pida da maxila assistida com mini-implantes ou MARPE: em busca de um movimento ortop\u00e9dico puro","volume":"15","author":"Suzuki \n              H,","year":"2016","unstructured":"Suzuki \n              H, \n            \n            \n              Moon \n              W, \n            \n            \n              Previdente \n              LH, \n            \n            \n              Suzuki \n              SS, \n            \n            \n              Garcez \n              AS, \n            \n            \n              Consolaro \n              A. \n            \n          \n          Expans\u00e3o r\u00e1pida da maxila assistida com mini-implantes ou MARPE: em busca de um movimento ortop\u00e9dico puro. 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J Clin Orthod. 2013;47:375\u2013381."},{"issue":"2","key":"i0003-3219-88-5-649-b15","series-title":"Int Orthod","first-page":"177","article-title":"Intra-arch widths: a meta-analysis","volume":"11","author":"Lombardo \n              L,","year":"2013 Jun","unstructured":"Lombardo \n              L, \n            \n            \n              Setti \n              S, \n            \n            \n              Molinari \n              C, \n            \n            \n              Siciliani \n              G. \n            \n          \n          Intra-arch widths: a meta-analysis. Int Orthod. 2013 Jun;11(2):177\u2013192."},{"key":"i0003-3219-88-5-649-b16","series-title":"Angle Orthod","first-page":"145","article-title":"Optimal palatal configuration for miniscrew applications","volume":"80","author":"Lombardo \n              L,","year":"2010","unstructured":"Lombardo \n              L, \n            \n            \n              Gracco \n              A, \n            \n            \n              Zampini \n              F, \n            \n            \n              Stefanoni \n              F, \n            \n            \n              Mollica \n              F. \n            \n          \n          Optimal palatal configuration for miniscrew applications. 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Am J Orthod Dentofacial Orthop. 2017;151:259\u2013266."},{"key":"i0003-3219-88-5-649-b41","series-title":"Angle Orthod","first-page":"913","article-title":"Open bite treatment using clear aligners","volume":"83","author":"Guarneri \n              MP,","year":"2013","unstructured":"Guarneri \n              MP, \n            \n            \n              Oliverio \n              T, \n            \n            \n              Silvestre \n              I, \n            \n            \n              Lombardo \n              L, \n            \n            \n              Siciliani \n              G. \n            \n          \n          Open bite treatment using clear aligners. Angle Orthod. 2013;83:913\u2013919."},{"key":"i0003-3219-88-5-649-b42","series-title":"BMC Oral Health","first-page":"69","article-title":"Braces versus Invisalign\u00ae: gingival parameters and patients' satisfaction during treatment: a cross-sectional study","volume":"15","author":"Azaripour \n              A,","year":"2015","unstructured":"Azaripour \n              A, \n            \n            \n              Weusmann \n              J, \n            \n            \n              Mahmoodi \n              B, \n            \n            et al. \n          Braces versus Invisalign\u00ae: gingival parameters and patients' satisfaction during treatment: a cross-sectional study. BMC Oral Health. 2015;15:69."},{"key":"i0003-3219-88-5-649-b43","series-title":"J Orofac Orthop","first-page":"240","article-title":"Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances","volume":"76","author":"Abbate \n              GM,","year":"2015","unstructured":"Abbate \n              GM, \n            \n            \n              Caria \n              MP, \n            \n            \n              Montanari \n              P, \n            \n            et al. \n          Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. 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Am J Orthod Dentofacial Orthop. 2013;143:426\u2013435."},{"key":"i0003-3219-88-5-649-b09","series-title":"Dental Press J Orthod","first-page":"12","article-title":"Interview with Won Moon","volume":"18","author":"Moon \n              W,","year":"2013","unstructured":"Moon \n              W, \n            \n            \n              Machado \n              A. \n            \n          \n          Interview with Won Moon. Dental Press J Orthod. 2013;18:12\u201328."},{"key":"i0003-3219-88-5-649-b10","series-title":"Ci\u00eancia e Odontologia casos cl\u00ednicos baseado em evid\u00eancias cient\u00edfica","first-page":"232","article-title":"Uma nova alternativa para a expans\u00e3o r\u00e1pida da maxila assistida por mini-implantes usada para a corre\u00e7\u00e3o ortop\u00e9dica em paciente Classe III esquel\u00e9tica em crescimento","author":"Curado \n              MM,","year":"2015","unstructured":"Curado \n              MM, \n            \n            \n              Suzuki \n              SS, \n            \n            \n              Suzuki \n              H, \n            \n            \n              Garcez \n              AS. \n            \n          \n          Uma nova alternativa para a expans\u00e3o r\u00e1pida da maxila assistida por mini-implantes usada para a corre\u00e7\u00e3o ortop\u00e9dica em paciente Classe III esquel\u00e9tica em crescimento. In: Junqueira JLC, Napimoga MH, eds. Ci\u00eancia e Odontologia casos cl\u00ednicos baseado em evid\u00eancias cient\u00edfica. Campinas: Mundi Brasil;2015:232\u2013237."},{"key":"i0003-3219-88-5-649-b11","series-title":"Rev Cl\u00edn Ortod Dental Press","first-page":"110","article-title":"Expans\u00e3o r\u00e1pida da maxila assistida com mini-implantes ou MARPE: em busca de um movimento ortop\u00e9dico puro","volume":"15","author":"Suzuki \n              H,","year":"2016","unstructured":"Suzuki \n              H, \n            \n            \n              Moon \n              W, \n            \n            \n              Previdente \n              LH, \n            \n            \n              Suzuki \n              SS, \n            \n            \n              Garcez \n              AS, \n            \n            \n              Consolaro \n              A. \n            \n          \n          Expans\u00e3o r\u00e1pida da maxila assistida com mini-implantes ou MARPE: em busca de um movimento ortop\u00e9dico puro. 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J Clin Orthod. 1987;21:781\u2013788."},{"key":"i0003-3219-88-5-649-b20","series-title":"Angle Orthod","first-page":"881","article-title":"Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review","volume":"85","author":"Rossini \n              G,","year":"2015","unstructured":"Rossini \n              G, \n            \n            \n              Parrini \n              S, \n            \n            \n              Castroflorio \n              T, \n            \n            \n              Deregibus \n              A, \n            \n            \n              Debernardi \n              CL. \n            \n          \n          Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. 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Angle Orthod. 2017;87:11\u201318."},{"key":"i0003-3219-88-5-649-b22","series-title":"Angle Orthod","first-page":"113","article-title":"Disharmony in tooth size and its relation to the analysis and treatment of malocclusion","volume":"28","author":"Bolton \n              WA.","year":"1958","unstructured":"Bolton \n              WA. \n            \n          \n          Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. Angle Orthod. 1958;28:113\u2013130."},{"key":"i0003-3219-88-5-649-b23","series-title":"Orthodontics and Dentofacial Orthopedics","first-page":"35","author":"McNamara \n              JA\n              Jr,","year":"2001","unstructured":"McNamara \n              JA\n              Jr, \n            \n            \n              Brudon \n              WL. \n            \n          \n          Orthodontics and Dentofacial Orthopedics. Needham, MA: Needham Press;2001; 35\u201336."},{"key":"i0003-3219-88-5-649-b24","series-title":"Rep Congr Eur Orthod Soc","first-page":"131","article-title":"Midpalatal suture expansion studies by the implant method over a seven-year period","volume":"40","author":"Kerbs \n              A.","year":"1964","unstructured":"Kerbs \n              A. \n            \n          \n          Midpalatal suture expansion studies by the implant method over a seven-year period. Rep Congr Eur Orthod Soc. 1964;40:131\u2013142."},{"key":"i0003-3219-88-5-649-b25","series-title":"Angle Orthod","first-page":"291","article-title":"Nonsurgical rapid maxillary alveolar expansion in adults: a clinical evaluation","volume":"67","author":"Handelman \n              CS.","year":"1997","unstructured":"Handelman \n              CS. \n            \n          \n          Nonsurgical rapid maxillary alveolar expansion in adults: a clinical evaluation. 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Am J Orthod. 1980;77:500\u2013507."},{"key":"i0003-3219-88-5-649-b28","series-title":"Am J Orthod","first-page":"41","article-title":"Skeletal and dental changes accompanying rapid midpalatal suture opening","volume":"58","author":"Wertz \n              RA.","year":"1970","unstructured":"Wertz \n              RA. \n            \n          \n          Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod. 1970;58:41\u201366."},{"key":"i0003-3219-88-5-649-b29","series-title":"Br J Oral Maxillofac Surg","first-page":"268","article-title":"Transpalatal distraction as a method of maxillary expansion","volume":"37","author":"Mommaerts \n              MY.","year":"1999","unstructured":"Mommaerts \n              MY. \n            \n          \n          Transpalatal distraction as a method of maxillary expansion. 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Am J Orthod Dentofacial Orthop. 2010;137:304.e1\u2013e12."},{"key":"i0003-3219-88-5-649-b39","series-title":"World J Orthod","first-page":"337","article-title":"Upper lip changes correlated with maxillary incisor movement in 65 orthodontically treated adult patients","volume":"9","year":"2008","unstructured":"Mirabella D1, Bacconi S, Gracco A, Lombardo L, Siciliani G. Upper lip changes correlated with maxillary incisor movement in 65 orthodontically treated adult patients. 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Angle Orthod. 2013;83:913\u2013919."},{"key":"i0003-3219-88-5-649-b42","series-title":"BMC Oral Health","first-page":"69","article-title":"Braces versus Invisalign\u00ae: gingival parameters and patients' satisfaction during treatment: a cross-sectional study","volume":"15","author":"Azaripour \n              A,","year":"2015","unstructured":"Azaripour \n              A, \n            \n            \n              Weusmann \n              J, \n            \n            \n              Mahmoodi \n              B, \n            \n            et al. \n          Braces versus Invisalign\u00ae: gingival parameters and patients' satisfaction during treatment: a cross-sectional study. BMC Oral Health. 2015;15:69."},{"key":"i0003-3219-88-5-649-b43","series-title":"J Orofac Orthop","first-page":"240","article-title":"Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances","volume":"76","author":"Abbate \n              GM,","year":"2015","unstructured":"Abbate \n              GM, \n            \n            \n              Caria \n              MP, \n            \n            \n              Montanari \n              P, \n            \n            et al. \n          Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. J Orofac Orthop. 2015;76:240\u2013250."},{"key":"i0003-3219-88-5-649-b44","series-title":"Prog Orthod","first-page":"28","article-title":"Changes in the oral environment after placement of lingual and labial orthodontic appliances","volume":"14","author":"Lombardo \n              L,","year":"2013","unstructured":"Lombardo \n              L, \n            \n            \n              Ortan \n              Y\u00d6, \n            \n            \n              Gorgun \n              \u00d6, \n            \n            \n              Panza \n              C, \n            \n            \n              Scuzzo \n              G, \n            \n            \n              Siciliani \n              G. \n            \n          \n          Changes in the oral environment after placement of lingual and labial orthodontic appliances. Prog Orthod. 2013;14:28."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/88\/5\/article-p649.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/88\/5\/649\/1388566\/111617-790_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/88\/5\/article-p649.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/88\/5\/article-p649.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:09:27Z","timestamp":1780067367000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/88\/5\/article-p649.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9]]},"references-count":88,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.2319\/111617-790.1","relation":{},"ISSN":["0003-3219","1945-7103"],"issn-type":[{"value":"0003-3219","type":"print"},{"value":"1945-7103","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9]]}}}