maxillary expansion between surgical and non-surgical modalities
A correct transverse skeletal relationship between the jaws is essential for stable and functional occlusion. Maxillary transverse hypoplasia is associated primarily with functional impairments, such as posterior unilateral or bilateral cross bite, dental crowding, reduced nasal respiratory function or anterior-posterior skeletal anomalies.
Transverse malocclusions due to maxillary width deficiency have been treated with maxillary expansion in children and adolescents. Clinically, skeletal correction of this transverse discrepancy by orthodontic means alone is only successful before skeletal maturity, i.e. before closure of the mid-palatal suture around the age of 14-16 years in girls and 16-18 years in boys. With advancing maturity, the rigidity of the skeletal components limits the extent of expansion causing unwanted effects such as tipping of posterior teeth, fenestration of the buccal cortex and above all unstable expansion. Orthodontists and maxillofacial surgeons have resorted to the principles of distraction osteogenesis in surgically assisted rapid maxillary expansion (SARME) to widen the maxilla and correct posterior crossbite in skeletally mature patients. On the other hand, surgically assisted maxillary expansion could be considered a costly procedure, with several side effects and risks that many patients presenting to the orthodontic office might refuse.
The presented study aims to compare the effects of both surgical and non-surgical maxillary expansion methods in skeletally mature patients.
Patients and methods:
Surgical and non-surgical maxillary expansion techniques are applied to skeletally mature patients presenting with transverse maxillary deficiency. Diagnosis and post expansion assessment were performed using Cone Beam Computed Tomography.
Results and conclusion:
Merits and demerits of surgical and none-surgical maxillary expansion techniques as well as their skeletal and dental effects will be presented. A rationale for clinical decision making will be provided.