title: Complications in transpalatal distraction osteogenesis: a retrospective clinical study.
abstract: OBJECTIVE
  Transpalatal distraction osteogenesis is a bone-borne technique to expand the maxilla and has become a routine method in treating patients with transverse maxillary hypoplasia. Limited reports concerning treatment difficulties have been published. The purpose of this study was to investigate and categorize the short- and middle-term incidence of peri- and postoperative difficulties (categorized by the classification of Paley in problems, obstacles, and complications). The signs of adverse dental and periodontal effects were established at least 1 year after removal of the distractor.
  
  
  METHODS
  A total of 73 patients (27 male, 46 female; mean age: 28 years; range: 9-59) that underwent bone-borne SARPE in 3 centers were retrospectively investigated. Clinical follow-up was performed in 63 patients after an average period of 23.9 months (range: 6-63 months).
  
  
  RESULTS
  Twenty-seven problems (mainly appliance related), 10 obstacles (appliance-related and asymmetric maxillary expansion), and 1 complication (premature loss of the TPD-module, due to lack of space, in a cleft patient) occurred. Clinical examination showed minimal periodontal damage (gingival recession on 15 sites and pocket depths 4-5 mm in 11 sites). In 28.6% of the incisors radiographic signs of external apical root resorption were seen.
  
  
  CONCLUSIONS
  Bone-borne SARPE is a reliable technique with predictable outcomes. These results suggest that bone-borne SARPE is associated with a low incidence of dental and periodontal damage. Nevertheless, further research, preferably in randomized controlled design, is needed to evaluate the long-term effects and stability.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Centre, Amsterdam, The Netherlands. cra.verlinden@vumc.nl
authors.forename: Charlotte R A
authors.initials: CR
authors.lastname: Verlinden
authors.forename: Peter G
authors.initials: PG
authors.lastname: Gooris
authors.forename: Alfred G
authors.initials: AG
authors.lastname: Becking
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004868:Equipment Failure; D005260:Female; D005889:Gingival Recession / Q000209:etiology*; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery; D008844:Micrognathism / Q000601:surgery; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000009:adverse effects*; D010155:Palatal Expansion Technique / Q000009:adverse effects*; D010514:Periodontal Pocket / Q000209:etiology*; D012189:Retrospective Studies; D012391:Root Resorption / Q000209:etiology*; D055815:Young Adult