title: Rapid maxillary expansion after secondary alveolar bone graft in a patient with bilateral cleft lip and palate.
abstract: OBJECTIVE
  To verify the effects of rapid maxillary expansion performed after secondary alveolar bone graft in one patient.
  
  
  METHODS
  Department of Orthodontics of the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo.
  
  
  METHODS
  The patient had bilateral cleft lip and palate, had already had a bone graft, and showed a relapsing maxillary constriction in need of correction.
  
  
  METHODS
  A fixed dental-mucous-bone-supported expander corrected the maxillary constriction.
  
  
  METHODS
  Measurements were obtained from dental casts, including transverse dimensions (intercanine distance [IC], interfirst premolar distance [IP], and interfirst molar distance [IM]) and measurements of the grafted area (interfirst premolar/central incisors [IPI] and interfirst premolar/canine [IPC]) to observe the changes. Clinical and radiographic analyses were done through direct view.
  
  
  RESULTS
  The occlusal radiograph of the maxilla after expansion showed opening of the intermaxillary suture in the premaxillary area, which was clinically confirmed by the diastema between the maxillary central incisors. No radiographic alteration was observed in the grafted area. The transverse measurements of the dental casts (IC, IP, and IM) showed a significant increase. The measurements of the teeth adjacent to the grafted area, IPI and IPC, increased.
  
  
  CONCLUSIONS
  The orthopedic effect of rapid maxillary expansion after bone graft was verified. Nevertheless, additional studies are necessary to define any side effects in patients submitted to bone graft.
authors.affiliation: Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil. sandrab@usp.br
authors.forename: Arlete de Oliveira
authors.initials: Ade O
authors.lastname: Cavassan
authors.forename: Marcelo D'Albuquerque
authors.initials: MD
authors.lastname: de Albuquerque
authors.forename: Leopoldino Capelozza
authors.initials: LC
authors.lastname: Filho
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation; D002972:Cleft Palate / Q000601:surgery / Q000628:therapy*; D003970:Diastema; D006801:Humans; D008297:Male; D010155:Palatal Expansion Technique; D012008:Recurrence