Surgical-orthodontic correction of transverse maxillary deficiency.
A conservative osteotomy of the zygomaticomaxillary buttress in combination with a rapid palatal expansion appliance is a dependable technique for the treatment of horizontal maxillary deficiency in adults. This procedure has been used successfully in 56 patients in our series, but 17 patients (30 per cent) required a midpalatal osteotomy. In two patients, overexpansion was not achieved because of necrosis of the mucosa. In three other patients, expansion had to proceed at a slower pace because of mucosal ulceration. There have been no other complications. The procedure is indicated mainly in those patients with a horizontal deficiency who do not require subsequent surgery, but for some patients it may be the preliminary procedure. Twelve patients (21 per cent) had subsequent orthognathic surgery. Follow-up has been from 1 to 12 years and there has been no relapse. In our opinion, the zygomaticomaxillary buttress is the primary area of resistance to lateral movement of the maxilla by rapid maxillary expansion appliances.
Lehman
J A
JA
Northeastern Ohio Universities College of Medicine, Akron.
Haas
A J
AJ
D000328:Adult; D003393:Cranial Sutures / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery* / Q000628:therapy; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery; D008875:Middle Aged; D009967:Orthodontic Appliances; D010027:Osteotomy / Q000379:methods; D010155:Palatal Expansion Technique / Q000295:instrumentation