Nonsurgical treatment of an adult patient with severe transversal skeletal discrepancy: Tooth bone-borne tandem expander and hybrid aligner approach.

Background: Although they have proven effective in the resolution of mild to moderate malocclusions, aligners demonstrate substantial limitations. More complex malocclusions therefore require a combination of auxiliaries, or a hybrid approach involving both aligners and fixed appliances, such as miniscrew-supported appliances or sectionals. This case report presents a 25-year-old female patient with a severe transversal discrepancy associated with an anterior open-bite tendency effectively treated with a tooth bone-borne palatal expander characterized by two expansion screws (tandem expander) and a hybrid treatment with aligners.