Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism.
A transverse maxillary deficiency in an adult is a challenging problem, especially when it is combined with a severe anteroposterior jaw discrepancy. The demand for nonsurgical maxillary expansion might increase as patients and clinicians try to avoid a 2-stage surgical procedure-surgically assisted rapid palatal expansion followed by orthognathic surgery-and detrimental periodontal effects and relapse. In this regard, a miniscrew-assisted rapid palatal expansion was devised and used to treat a 20-year-old patient who had severe transverse discrepancy and mandibular prognathism. Sufficient maxillary orthopedic expansion with minimal tipping of the buccal segment was achieved preoperatively, and orthognathic surgery corrected the anteroposterior discrepancy. The periodontal soundness and short-term stability of the maxillary expansion were confirmed both clinically and radiologically. Effective incorporation of orthodontic miniscrews for transverse correction might help eliminate the need for some surgical procedures in patients with complex craniofacial discrepancies by securing the safety and stability of the treatment, assuming that the suture is still patent.
Lee
Kee-Joon
KJ
Department of Orthodontics, Oral Science Research Center, Institute of Craniofacial Deformity, Yonsei University, Seoul, Korea. orthojn@yuhs.ac
Park
Young-Chel
YC
Park
Joo-Young
JY
Hwang
Woo-Sang
WS
D001863:Bone Screws; D002508:Cephalometry; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery / Q000628:therapy*; D008334:Mandible / Q000002:abnormalities / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D008904:Miniaturization; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D056948:Orthognathic Surgical Procedures; D019340:Osteotomy, Le Fort; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D011378:Prognathism / Q000601:surgery / Q000628:therapy*; D055815:Young Adult