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Evaluation of surgically assisted rapid maxillary expansion with or without pterygomaxillary disjunction based upon preoperative and post-expansion 3D computed tomography data

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Abstract

Purpose, methods

This study (50 patients; Ø25 years) compared surgically assisted rapid maxillary expansion (SARME) with (±PP) to SARME without pterygomaxillary (−PP) disjunction due to dentoskeletal effects in 3D CT preoperatively and Ø11 weeks post-expansion.

Results

In t test, SARME−PP declined in transverse width from anterior to posterior but more symmetrically than SARME+PP. It produced more segmental inclination and vestibular bone resorption in the premolars. SARME+PP also declined in transverse width from anterior to posterior but more asymmetrically with an extreme convergence to the molars. It produced more segmental inclination and vestibular bone resorption (second molar) in the molars and a palatal bone plate thickness increase in the second premolar. With variance analysis, a further differentiation between the two independent groups due to secondary variables was made: SARME+PP produced the biggest decline in transverse width (patients <20 years) and the biggest segmental outward inclination from anterior to posterior in patients with bone-borne devices. SARME−PP in patients <20 years and SARME+PP in patients >20 years both produced the biggest lateral pterygoid bending.

Conclusion

Pterygomaxillary disjunction should be based on patient age and individual requirements, i.e., in patients <20 years (SARME−PP) and >20 years (SARME+PP).

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References

  1. Banning LM, Gerard N, Steinberg BJ, Bogdanoff E (1996) Treatment of transverse maxillary deficiency with emphasis on surgically assisted rapid maxillary expansion. Compend Contin Educ Dent 17:170–178

    PubMed  CAS  Google Scholar 

  2. Glassman AS, Nahigian SJ, Medway JM, Aronowitz HI (1984) Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases. Am J Orthod 86:207–213

    Article  PubMed  CAS  Google Scholar 

  3. Bell RA (1982) A review of maxillary expansion in relation to rate of expansion and patients age. Am J Orthod 81:32–37

    Article  PubMed  CAS  Google Scholar 

  4. Bell WH, Epker BN (1979) Surgical orthodontic correction of horizontal maxillary deficiency. J Oral Surg 37:879

    Google Scholar 

  5. Suri L, Taneja P (2008) Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop 133:290–302

    Article  PubMed  Google Scholar 

  6. Timms DJ, Vero D (1981) The relationship of rapid maxillary expansion to surgery with special reference to midpalatal synostosis. Br J Oral Surg 19:180–196

    Article  PubMed  CAS  Google Scholar 

  7. Melsen B (1975) Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod 68:42–52

    Article  PubMed  CAS  Google Scholar 

  8. Persson M, Thilander B (1977) Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 15:670–675

    Google Scholar 

  9. Lines PA (1975) Adult rapid maxillary expansion with corticotomy. Am J Orthod 67:44–56

    Article  PubMed  CAS  Google Scholar 

  10. Bell WH, Jacobs JD (1979) Surgical-orthodontic correction of horizontal maxillary deficiency. J Oral Surg 37:897–902

    PubMed  CAS  Google Scholar 

  11. Kennedy JW 3rd, Bell WH, Kimbrough OL, James WB (1976) Osteotomy as an adjunct to rapid maxillary expansion. Am J Orthod 70:123–137

    Article  PubMed  Google Scholar 

  12. Moss JP (1968) Rapid expansion of the maxillary arch. Part I. J Pract Orthod 2:165–171

    Google Scholar 

  13. Moss JP (1968) Rapid expansion of the maxillary arch. Part II. J Pract Orthod 2:215–223

    CAS  Google Scholar 

  14. Lines PA (1975) Adult rapid maxillary expansion with corticotomy. Am J Orthod 67:44–56

    Article  PubMed  CAS  Google Scholar 

  15. Garib DG, Castanha Henriques JF, Janson G, Freitas MR, Coelho RA (2005) Rapid maxillary expansion—tooth tissue-borne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects. Angle Orthod 75:548–557

    PubMed  Google Scholar 

  16. Lanigan DT, Tumban DE (1987) Carotid-cavernous sinus fistula following Le Fort I osteotomy. J Oral Maxillofac Surg 45:969–975

    Article  PubMed  CAS  Google Scholar 

  17. Lanigan DT, Hey JH, West RA (1990) Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies. J Oral Maxillofac Surg 48:561–573

    Article  PubMed  CAS  Google Scholar 

  18. Lanigan DT, Hey JH, West RA (1991) Major vascular complications of orthognathic surgery: false aneurysms and arteriovenous fistulas following orthognathic surgery. J Oral Maxillofac Surg 49:571–575

    Article  PubMed  CAS  Google Scholar 

  19. Lanigan DT, Romanchuk K, Olson CK (1991) Ophthalmic complications associated with orthognathic surgery. J Oral Maxillofac Surg 51:480–494

    Article  Google Scholar 

  20. Ueki K, Nakagawa K, Marukawa K, Yamamoto E (2004) Le Fort I maxillary osteotomy using an ultrasonic bone curette to fracture the pterygoid plates. J Cranio Maxillofac Surg 32:381–386

    Article  Google Scholar 

  21. Hiranuma Y, Yamamoto Y, Iizuka T (1988) Strain Distribution during separation of the pterygomaxillary suture by osteotomes. Comparison between Obwegeser's osteotome and Swan's neck osteotome. J Cranio Maxillofac Surg 16:13–17

    Article  CAS  Google Scholar 

  22. Cruz AAV, dos Santos AC (2006) Case Report: blindness after Le Fort I osteotomy: a possible complication associated with pterygomaxillary separation. J Cranio Maxillofac Surg 34:210–216

    Google Scholar 

  23. Bays RA, Greco JM (1992) Surgically assisted rapid palatal expansion: an outpatient technique with long term stability. J Oral Maxillofac Surg 50:266–270

    Article  Google Scholar 

  24. Han IH, An JS, Gu H, Kook MS, Park HJ, Oh HK (2006) Effects of pterygomaxillary separation on skeletal and dental changes following surgically-assisted rapid maxillary expansion. J Korean Assoc Macillofac Plast Reconstr Surg 28:320–328

    Google Scholar 

  25. Vasconcelos B, Caubi AF, Dias E, Lago CA, Porto GG (2006) Surgically assisted rapid maxillary expansion: a preliminary study. Rev Bras Otorrinolaringol 72:457–461

    Google Scholar 

  26. Landes C, Laudemann K, Schübel F, Petruchin O, Mack M, Kopp S, Sader R (2009) Comparison of tooth-borne and bone-borne devices in SARME by 3D CT-monitoring: transverse dental and skeletal maxillary expansion, segmental inclination, dental tipping and vestibular bone resorption. Craniofac Surg 20(4):1132–1141

    Google Scholar 

  27. Holberg C, Rudzki-Janson K (2006) Stresses at the cranial Base induced by rapid maxillary expansion. Angle Orthod 76:543–550

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Oral, Maxillofacial and Plastic Facial Surgery, Goethe University, Frankfurt, Germany

    Katharina Laudemann, Oksana Petruchin, Robert Sader & Constantin A. Landes

  2. Department of Diagnostic and Interventional Radiology, Goethe University, Frankfurt, Germany

    Martin G. Mack

  3. Department of Orthodontics, Goethe University, Frankfurt, Germany

    Stefan Kopp

  4. Mund-, Kiefer- und Plastische Gesichtschirurgie, Theodor Stern Kai 7, Haus 21G, 60596, Frankfurt am Main, Germany

    Katharina Laudemann

Authors
  1. Katharina Laudemann
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  2. Oksana Petruchin
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  3. Martin G. Mack
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  4. Stefan Kopp
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  5. Robert Sader
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  6. Constantin A. Landes
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Correspondence to Katharina Laudemann.

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Laudemann, K., Petruchin, O., Mack, M.G. et al. Evaluation of surgically assisted rapid maxillary expansion with or without pterygomaxillary disjunction based upon preoperative and post-expansion 3D computed tomography data. Oral Maxillofac Surg 13, 159–169 (2009). https://doi.org/10.1007/s10006-009-0167-3

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