Soft tissue healing after parasagittal palatal incisions in segmental maxillary surgery: a review of 311 patients.
OBJECTIVE
This study retrospectively evaluated the soft tissue healing after using parasagittal soft tissue incisions for surgical segmental maxillary expansion.


METHODS
The records of 311 patients (224 females, 87 males), with an average age of 28.5 years (range, 12 to 62 years) who had transverse maxillary hypoplasia, were retrospectively evaluated. All patients underwent segmental maxillary osteotomies, surgical maxillary expansion greater than 5 mm, and placement of midpalatal porous block hydroxyapatite (PBHA). Parasagittal palatal soft tissue incisions were used to facilitate expansion, minimize soft tissue damage, and maintain soft tissue coverage over the PBHA implants. At postoperative follow-up visits, any signs or symptoms of complications associated with the use of the parasagittal incisions were recorded.


RESULTS
Average patient follow-up was 3.4 years (range, 1.0 to 7.2 years). In 293 patients (94%), the palates healed uneventfully without complications. Eighteen patients (6%) had complications; 9 (2.9%) had infections associated with the midpalatal implants, 8 (2.6%) had oronasal communications, and 1 (0.3%) had problems associated with a palatal wire. Six patients with midpalatal implant problems required removal of the implant, 4 patients required closure of their oronasal communications, and 1 patient required removal of a palatal wire. Therefore, 11 patients (3.5%) required minor secondary surgical procedures. No teeth or alveolar bone were lost in any of the cases.


CONCLUSIONS
The use of parasagittal palatal incisions appears to be a safe technique for soft tissue management during large surgical maxillary expansions associated with segmental maxillary osteotomies and midpalatal placement of PBHA implants.
Wolford
Larry M
LM
Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&M University System, Dallas, TX, USA. lwolford@swbell.net
Rieche-Fischel
Oscar
O
Mehra
Pushkar
P
D000293:Adolescent; D000328:Adult; D002648:Child; D017886:Durapatite; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D008447:Maxillofacial Prosthesis; D008844:Micrognathism / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery*; D016155:Oral Fistula / Q000209:etiology; D019340:Osteotomy, Le Fort / Q000009:adverse effects / Q000379:methods*; D010155:Palatal Expansion Technique; D021362:Palate, Hard / Q000002:abnormalities / Q000601:surgery*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing
D017886:Durapatite