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Published in: Oral and Maxillofacial Surgery 3/2009

01-09-2009 | Original Article

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

Authors: Katharina Laudemann, Oksana Petruchin, Martin G. Mack, Stefan Kopp, Robert Sader, Constantin A. Landes

Published in: Oral and Maxillofacial Surgery | Issue 3/2009

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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).
Literature
1.
go back to reference 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 17:170–178PubMed 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 17:170–178PubMed
2.
go back to reference Glassman AS, Nahigian SJ, Medway JM, Aronowitz HI (1984) Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases. Am J Orthod 86:207–213PubMedCrossRef Glassman AS, Nahigian SJ, Medway JM, Aronowitz HI (1984) Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases. Am J Orthod 86:207–213PubMedCrossRef
3.
go back to reference Bell RA (1982) A review of maxillary expansion in relation to rate of expansion and patients age. Am J Orthod 81:32–37PubMedCrossRef Bell RA (1982) A review of maxillary expansion in relation to rate of expansion and patients age. Am J Orthod 81:32–37PubMedCrossRef
4.
go back to reference Bell WH, Epker BN (1979) Surgical orthodontic correction of horizontal maxillary deficiency. J Oral Surg 37:879 Bell WH, Epker BN (1979) Surgical orthodontic correction of horizontal maxillary deficiency. J Oral Surg 37:879
5.
go back to reference Suri L, Taneja P (2008) Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop 133:290–302PubMedCrossRef Suri L, Taneja P (2008) Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop 133:290–302PubMedCrossRef
6.
go back to reference Timms DJ, Vero D (1981) The relationship of rapid maxillary expansion to surgery with special reference to midpalatal synostosis. Br J Oral Surg 19:180–196PubMedCrossRef Timms DJ, Vero D (1981) The relationship of rapid maxillary expansion to surgery with special reference to midpalatal synostosis. Br J Oral Surg 19:180–196PubMedCrossRef
7.
go back to reference Melsen B (1975) Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod 68:42–52PubMedCrossRef Melsen B (1975) Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod 68:42–52PubMedCrossRef
8.
go back to reference Persson M, Thilander B (1977) Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 15:670–675 Persson M, Thilander B (1977) Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 15:670–675
10.
go back to reference Bell WH, Jacobs JD (1979) Surgical-orthodontic correction of horizontal maxillary deficiency. J Oral Surg 37:897–902PubMed Bell WH, Jacobs JD (1979) Surgical-orthodontic correction of horizontal maxillary deficiency. J Oral Surg 37:897–902PubMed
11.
go back to reference Kennedy JW 3rd, Bell WH, Kimbrough OL, James WB (1976) Osteotomy as an adjunct to rapid maxillary expansion. Am J Orthod 70:123–137PubMedCrossRef Kennedy JW 3rd, Bell WH, Kimbrough OL, James WB (1976) Osteotomy as an adjunct to rapid maxillary expansion. Am J Orthod 70:123–137PubMedCrossRef
12.
go back to reference Moss JP (1968) Rapid expansion of the maxillary arch. Part I. J Pract Orthod 2:165–171 Moss JP (1968) Rapid expansion of the maxillary arch. Part I. J Pract Orthod 2:165–171
13.
go back to reference Moss JP (1968) Rapid expansion of the maxillary arch. Part II. J Pract Orthod 2:215–223 Moss JP (1968) Rapid expansion of the maxillary arch. Part II. J Pract Orthod 2:215–223
14.
15.
go back to reference 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 75:548–557PubMed 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 75:548–557PubMed
16.
go back to reference Lanigan DT, Tumban DE (1987) Carotid-cavernous sinus fistula following Le Fort I osteotomy. J Oral Maxillofac Surg 45:969–975PubMedCrossRef Lanigan DT, Tumban DE (1987) Carotid-cavernous sinus fistula following Le Fort I osteotomy. J Oral Maxillofac Surg 45:969–975PubMedCrossRef
17.
go back to reference Lanigan DT, Hey JH, West RA (1990) Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies. J Oral Maxillofac Surg 48:561–573PubMedCrossRef Lanigan DT, Hey JH, West RA (1990) Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies. J Oral Maxillofac Surg 48:561–573PubMedCrossRef
18.
go back to reference 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 49:571–575PubMedCrossRef 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 49:571–575PubMedCrossRef
19.
go back to reference Lanigan DT, Romanchuk K, Olson CK (1991) Ophthalmic complications associated with orthognathic surgery. J Oral Maxillofac Surg 51:480–494CrossRef Lanigan DT, Romanchuk K, Olson CK (1991) Ophthalmic complications associated with orthognathic surgery. J Oral Maxillofac Surg 51:480–494CrossRef
20.
go back to reference 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 32:381–386CrossRef 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 32:381–386CrossRef
21.
go back to reference 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 16:13–17CrossRef 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 16:13–17CrossRef
22.
go back to reference 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 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
23.
go back to reference Bays RA, Greco JM (1992) Surgically assisted rapid palatal expansion: an outpatient technique with long term stability. J Oral Maxillofac Surg 50:266–270CrossRef Bays RA, Greco JM (1992) Surgically assisted rapid palatal expansion: an outpatient technique with long term stability. J Oral Maxillofac Surg 50:266–270CrossRef
24.
go back to reference 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 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
25.
go back to reference 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 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
26.
go back to reference 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 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
27.
go back to reference Holberg C, Rudzki-Janson K (2006) Stresses at the cranial Base induced by rapid maxillary expansion. Angle Orthod 76:543–550PubMed Holberg C, Rudzki-Janson K (2006) Stresses at the cranial Base induced by rapid maxillary expansion. Angle Orthod 76:543–550PubMed
Metadata
Title
Evaluation of surgically assisted rapid maxillary expansion with or without pterygomaxillary disjunction based upon preoperative and post-expansion 3D computed tomography data
Authors
Katharina Laudemann
Oksana Petruchin
Martin G. Mack
Stefan Kopp
Robert Sader
Constantin A. Landes
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Oral and Maxillofacial Surgery / Issue 3/2009
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-009-0167-3

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