Case 19

Adolescent-Young adult (permanent dentition)

Problem

Severely constricted maxilla

Abnormal sagittal co-ordination of the jaws

Retrognathic mandible

Severe upper and moderate lower crowding

Severe Obstructive Sleep Apnea (OSA)

Treatment

Maxillary expansion

Extraction of 4 premolars

Orthodontic treatment with fixed appliances

Orthognathic surgery (mandibular correction)