Selective maxillary widening: distraction osteogenesis

Statement of the problems: Transverse maxillary deficiency may occur selectively in either anterior or posterior arch. As it is found in cases of dental crowding, impacted teeth and maxillary constriction that causes cross bite. Orthodontic treatment compensation or orthopedic devices not achieved stability and may compromise the periodontal tissue and facial esthetic. The need for a selective maxillary widening is fundamental.

Materials and methods: Fifteen patients, 10 females and 5 males between 15 and 20 years olds with selective transverse maxillary deficiency in anterior or posterior arch were treated with intraoral distraction osteogenesis.

Depending of the case is used a tooth-borne or a bone-borne devices. In anterior cases a bone-borne device with transpalatal bar or an interdental wire is adjust at first molar level. For posterior selective expansion uni-arm tooth borne device is adjust at molars level, it is necessary an osteosynthesis plate and interdental incisal wire at the anterior zone to avoid the maxillary expansion.

In surgery the devices were activated 2 mm, and after latency period were activated 1 mm daily to complete the planned expansion. To obtain the adequate stabilization it is necessary a consolidation period that consist in 60 to 90 days after distraction.

Results: All patients resulted with adequate dental interdigitation and excellent esthetics results. No anatomical structures were damaged or complications were observed.

Conclusions: In selective maxillary expansion distraction osteogenesis is an excellent and versatile surgical technique that provides an alternative to orthognatic surgery.

Conflict of interest: Synthes consultor.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Selective maxillary widening: distraction osteogenesis
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