title: Relapse and stability of surgically assisted rapid maxillary expansion: an anatomic biomechanical study.
abstract: OBJECTIVE
  This anatomic biomechanical study was undertaken to gain insight into the underlining mechanism of tipping of the maxillary segments during transverse expansion using tooth-borne and bone-borne distraction devices.
  
  
  METHODS
  An anatomic biomechanical study was performed on 10 dentate human cadaver heads using tooth-borne and bone-borne distraction devices.
  
  
  RESULTS
  The amount of tipping of the maxillary halves was greater in the tooth-borne group, but the difference was not significant. Four of the specimens demonstrated an asymmetrical widening of the maxilla.
  
  
  CONCLUSIONS
  Segmental tipping was seen in both study groups. In this anatomic model, tooth-borne distraction led to greater segmental tipping compared with bone-borne distraction. Keep in mind, however, that this anatomic model by no means depicts a patient situation, and any extrapolation from it must be done with great care. The fact that the tooth-borne group demonstrated greater tipping might reflect the general opinion that bone-borne distraction causes less segmental angulation than tooth-borne distraction. Some tipping was seen in the bone-borne group, suggesting that overcorrection to counteract relapse will be necessary with this treatment modality.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. m.koudstaal@erasmusmc.nl
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Koudstaal
authors.forename: Jeroen B J
authors.initials: JB
authors.lastname: Smeets
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Kleinrensink
authors.forename: Alcuin J M
authors.initials: AJ
authors.lastname: Schulten
authors.forename: Karel G H
authors.initials: KG
authors.lastname: van der Wal
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D002508:Cephalometry; D003799:Dental Stress Analysis; D006801:Humans; D008310:Malocclusion / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009967:Orthodontic Appliances; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D055502:Secondary Prevention; D013314:Stress, Mechanical; D013997:Time Factors; D014087:Tooth Movement Techniques