title: One-step transversal palatal distraction and maxillary repositioning: technical considerations, advantages, and long-term stability.
abstract: BACKGROUND
  Transversal maxillary hypoplasia in adolescence is a frequently seen pathology, which can be treated with a combination of surgery and orthodontic treatment to widen the maxilla in skeletally matured patients.We evaluated the advantages of a new surgical technique: Le Fort I distraction osteogenesis using a bone-borne device. Because relapse is one of the main problems in surgical maxillary expansion, long-term stability of this new technique was evaluated.
  
  
  METHODS
  Data from 4 adult patients with maxillary restriction, class III malocclusion, or maxillary malposition were collected preoperatively, 4 months after distraction, and 5 years after distraction. Measurements were recorded on dental models to detect palatal expansion at dental level; cephalograms by lateral and posteroanterior plane were analyzed to detect maxillary movements.
  
  
  RESULTS
  Maxillary measurements were substantially stable 5 years after distractions. Only minor dental movements occurred at the dental analysis after 5 years related to a lack of orthodontic contention without any compromise of the dental result (no crossbite relapse and class I stability).
  
  
  CONCLUSIONS
  Le Fort I with down-fracture for expansion and repositioning by bone-borne distractor device can [corrected] be used to simultaneously widen, advance, and vertically reposition the maxilla without causing healing problems, particularly using a rigid distraction device. Long-term stability can be achieved; however, further studies with a larger number of patients will be necessary for better evaluation.
authors.affiliation: Department of Oral and Maxillofacial Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cortese
authors.forename: Mauro
authors.initials: M
authors.lastname: Savastano
authors.forename: Germano
authors.initials: G
authors.lastname: Savastano
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Claudio
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D019340:Osteotomy, Le Fort; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D011474:Prosthesis Design; D012189:Retrospective Studies; D016896:Treatment Outcome