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CS Huang
CY Hsieh

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CS Huang
CY Hsieh

International Research Journal of Medicine and Biomedical Sciences
Vol.3 (2),pp. 15-29, November 2018
ISSN 2488-9032
Available online at
Author(s) retain the copyright of this article. Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License.

Case Study

ISW for the treatment of adult anterior crossbite with severe crowding combined facial asymmetry case

Chun-shuo HUANG1,2, Jian-hong YU*1,2 and Cheng-yen HSIEH1,2

1Department of Orthodontics, China Medical University Hospital, Taichung, Taiwan.
2School of Dentistry, College of Dentistry, China Medical University, Taichung, Taiwan.

*Corresponding Author: Email: kenkoyu(at)

date Received: September 18, 2018     date Accepted: November 5, 2018     date Published: November 16, 2018


The objective of this case report was to discuss ISW (Improved Super-elastic Ti-Ni alloy wire, developed by Tokyo Medical and Dental University) for the treatment of adult anterior crossbite with facial asymmetry and severe crowding. An adult female (29 years old) came to our clinic with a chief complaint of not able to chew food well and irregularity of her teeth. Clinical examination revealed right side Class III, left side Class I molar relationship, anterior crossbite and severe crowding combined with full mouth periodontitis and facial asymmetry with a mandible shift to left side. We decided to adopt orthodontic non-extraction treatment because the patient strongly refused to receive orthognathic surgery. Before orthodontic active treatment, the periodontal phase I therapy was performed and the results were controlled well. ISW and open coil spring for #26, 27 distalization were performed to facilitate the correction of anterior crossbite and relief of blocked-in #25. With the use of differential ISW MEAW technique and intermaxillary elastics(IME), severe dental crowding was corrected. The treatment was completed within 18 months and a desirable occlusion with adequate overbite and overjet was achieved.

Key words: ISW, skeletal Class III, non-surgical orthodontics, 3 incisor finish, ISW expansion arch and MEAW technique.

Huang et al