A transverse maxillary deficiency in an adult is a challenging problem, especially when it is combined with a severe antero-posterior jaw discrepancy. The demand for nonsurgical maxillary expansion might increase as patients and clinicians try to avoid a 2-stage surgical procedure—surgically assisted rapid palatal expansion followed by orthognathic surgery—and detrimental periodontal effects and relapse.

In this regard, a miniscrew-assisted rapid palatal expansion appliance can effectively incorporate orthodontic miniscrews for transverse correction and might help eliminate the need for some surgical procedures in patients with complex craniofacial discrepancies by securing the safety and stability of the treatment, assuming that the suture is still patent.