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Maxillary left second molar (27) was taken as the anchorage. During alignment 27 had almost taken up the place of the extracted 26 (figures 5 and ?and66). Figure?4 Pretreatment and post-treatment models showing the increase in intercanine, interpremolar and intermolar width. Figure?5 Maxillary arch photographs: before, during and after expansion. Figure?6 Maxillary occlusal models: before, during and after expansion. A single incisor extraction was performed as a space gaining method to relieve crowding, correct proclination and align the mandibular teeth. In the process, the mandibular arch was also expanded and teeth were aligned simultaneously with the corrections in the maxillary arch (figures 7 and ?and88). Figure?7 Mandibular occlusal photographs: before, during and after expansion. Figure?8 Mandibular occlusal models: before, during and after expansion. This was a unique case treated with an NiTi slow maxillary expander which converted the asymmetric ��V��-shaped maxillary arch into a well aligned symmetric ��U�� shaped arch, corrected crossbite. The anterior open bite was also corrected. With the treatment results, the patient was pleased with the aesthetic improvement and the enhanced functional ability to chew the food (figures 9 and ?and1010). Figure?9 Postexpansion intraoral photographs demonstrating correction of open bite and posterior crossbite. Figure?10 Postexpansion extraoral photographs occlusal and dental enhancement. Outcome and follow-up The patient was referred to the Oral & Maxillofacial unit for surgery to facilitate further cosmetic enhancement. Maxillary expansion using an NiTi expander coupled with fixed mechanotherapy yielded excellent outcome and also corrected the open bite with simultaneous alignment of the teeth. Discussion Narrow maxilla has been recognised from thousands of years.1 An estimated 25�C30% of all orthodontic patients can be benefited from maxillary expansion.2 Transverse maxillary expansion corrects posterior crossbite, which moves the maxilla forward, SB431542 cell line increases space in the arch and repositions the crowded permanent teeth.3 Broadly, expansion appliances can be categorised into two: rapid maxillary expansion (RME) appliances and slow maxillary expansion (SME) appliances. RME appliances generate heavy forces across the midpalatal suture and bring about split in the suture.4 This kind of suture opening brings about patient discomfort and can only be carried out until adolescence as the suture becomes increasingly tortuous and interdigitated as age advances.5 This patient presented to the department at an age of 24?years, so RME could not be the treatment of choice. SME appliances produces light force and opens the suture at a rate that is close to the maximum speed of bone formation.3 According to Storey,6 slow expansion produces suture separation at a rate that maintains the integrity of maxillary sutures by allowing for bone remodelling.