title: [Maxillary transversal expansion obtained by transpalatal distractor and Le Fort I osteotomy with posterior impaction of the maxilla, in one stage].
abstract: BACKGROUND
  The transpalatal distractor (TPD", Surgi-Tec, Bruges, Belgium) is a bone support device whose transversal expansion effect is well known in teenagers at the end of their growth and in adults. Surgical assisted rapid palatal expansion is usually carried out before the orthodontic treatment phase. The transversal gain is mainly seen at the anterior level, and can avoid, in some cases, extraction of bicuspids. It is difficult to correct a sizeable posterior transversal deficit using this technique, and patients presenting a complex dismorphosis must go through a second surgical phase to correct the vertical and sagittal abnormalities at the end of the orthodontic preparation.
  
  
  METHODS
  We describe a clinical case of posterior transversal surgical expansion, associated with posterior impaction of the maxilla, in one stage, at the end of orthodontic preparation. The osteotomies, the positioning of the distractor and the orthodontic apparatus enable the palatal transversal expansion to be modulated as required.
  
  
  CONCLUSIONS
  The advantages and limitations of this therapeutic technique are discussed.
authors.affiliation: Clinique d'Orthodontie (Pr R. Glineur), Hôpital Universitaire Erasme, Université Libre de Bruxelles, Belgique.
authors.forename: I
authors.initials: I
authors.lastname: Ponikelsky
authors.forename: A
authors.initials: A
authors.lastname: Balon-Perin
authors.forename: E
authors.initials: E
authors.lastname: Deroux
authors.forename: C
authors.initials: C
authors.lastname: Vervaet
authors.forename: R
authors.initials: R
authors.lastname: Glineur
mesh_terms: D000293:Adolescent; D001860:Bone Plates; D001864:Bone Wires; D005260:Female; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D016382:Orthodontic Appliance Design; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000295:instrumentation / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation