title: Transverse maxillary distraction in patients with periodontal pathology or insufficient tooth anchorage using custom-made devices.
abstract: OBJECTIVE
  We present our experience using modified Hyrax devices for treating transverse deficiencies of the maxilla in adult patients with periodontal pathology or insufficient tooth anchorage. The surgical technique, clinical indications, and results are discussed.
  
  
  METHODS
  Eight adult patients (6 females, 2 males) requiring maxillary expansion were studied prospectively between July 2002 and July 2007. All the patients had periodontal pathology or insufficient tooth anchorage preventing the use of conventional Hyrax devices. Patients underwent surgically assisted rapid maxillary expansion with the use of custom-made modified Hyrax devices (bone-borne or tooth-bone-borne devices). Patients received preoperatively (T1), at the end of distraction (T2), at removal of the expansion device (T3), and 12 months after surgery (T4) lateral and posterior anterior cephalograms and study models to measure the width of the anterior and posterior dental arches with a digital sliding calliper.
  
  
  RESULTS
  Mean age was 28.5 years (range, 18-45 years). A significant widening of the anterior (6.3 +/- 1.6 mm) and posterior (7.1 +/- 1.2 mm) dental arches was demonstrated. No significant differences were found when comparing T3 with T4 measures. No significant complications were found.
  
  
  CONCLUSIONS
  The results indicated that maxillary expansion with custom-made devices in adults was an easy, affordable, predictable and stable technique without significant complications in patients who suffer periodontal pathology or patients without enough dental support.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Povisa Hospital, Vigo, Spain. jfsan@mundo-r.com
authors.forename: Jacinto
authors.initials: J
authors.lastname: Fernández-Sanromán
authors.forename: Montserrat González
authors.initials: MG
authors.lastname: Donascimento
authors.forename: Alberto Costas
authors.initials: AC
authors.lastname: López
authors.forename: Martín Fernández
authors.initials: MF
authors.lastname: Ferro
authors.forename: Ibon Almandoz
authors.initials: IA
authors.lastname: Berrondo
mesh_terms: D000293:Adolescent; D000328:Adult; D003393:Cranial Sutures / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery; D008297:Male; D008310:Malocclusion / Q000150:complications / Q000628:therapy*; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D008875:Middle Aged; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation / Q000379:methods*; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D010510:Periodontal Diseases / Q000150:complications; D011446:Prospective Studies; D016896:Treatment Outcome