title: Transverse maxillary distraction with a bone-anchored appliance: dento-periodontal effects and clinical and radiological results.
abstract: In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillary distraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique.
authors.affiliation: Department of Maxillo-Facial Surgery, University of Turin, C.so A.M. Dogliotti 14, 10126 Torino, Italy. guglielmo.ramieri@unito.it
authors.forename: G A
authors.initials: GA
authors.lastname: Ramieri
authors.forename: M C
authors.initials: MC
authors.lastname: Spada
authors.forename: M
authors.initials: M
authors.lastname: Austa
authors.forename: S D
authors.initials: SD
authors.lastname: Bianchi
authors.forename: S
authors.initials: S
authors.lastname: Berrone
mesh_terms: D000328:Adult; D002508:Cephalometry; D003724:Dental Arch / Q000033:anatomy & histology; D005260:Female; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000295:instrumentation*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000295:instrumentation*; D010155:Palatal Expansion Technique; D010159:Palate / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D020886:Somatosensory Disorders / Q000209:etiology; D014086:Tooth Mobility / Q000209:etiology