• Viet Anh Nguyen, Ngoc Anh Nguyen, Hong Le Doan, Thi Hanh Pham, and Bich Ngoc Doan.
• Faculty of Dentistry, Phenikaa University, Hanoi, Vietnam.
• Medicine (Baltimore). 2024 Dec 6; 103 (49): e40832e40832.

RationaleCurrent literature describes only 2 cases combining miniscrew-assisted rapid palatal expansion (MARPE) with lingual appliances. These cases require 2 impressions, 1 before and 1 after palatal expansion, to ensure accurate lingual appliance placement, potentially increasing treatment time and cost. This case report aimed to demonstrate a modified workflow of combining MARPE and lingual appliances in managing an adult patient with anteroposterior and transversal discrepancies, requiring only a single digital impression for both fabrication and positioning.Patient ConcernsA 29-year-old female presented with anterior and posterior crossbites, a class III skeletal relationship, and maxillary constriction. The patient desired a nonsurgical and esthetic treatment approach.DiagnosesThe patient was diagnosed with a class III malocclusion with anterior and posterior crossbite on a skeletal hypodivergent class III relationship and upper posterior constriction.InterventionsTreatment included MARPE for skeletal expansion, digitally planned lingual appliances for tooth alignment, and lower arch distalization for class III correction. A modified appliance sequence was utilized for optimal expansion retention and lingual bracket transfer accuracy.OutcomesThe treatment successfully corrected the crossbites, improved dental and facial esthetics, and achieved partial skeletal correction.LessonsThe combination of MARPE and lingual appliances offers a viable treatment alternative that prioritizes both esthetics and effective skeletal expansion for nonsurgical and esthetic management of adult class III malocclusion with maxillary constriction. The modified workflow, employing a single digital impression, may offer several advantages, including reduced treatment duration and associated costs, prolonged postexpansion retention, and minimized aesthetic impact of midline diastema.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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