title: Midfacial Protraction With Skeletal Anchorage After Pterygomaxillary Separation.
abstract: The present article reports the treatment of a 7-year-old girl with maxillary hypoplasia associated with multiple tooth agenesis through maxillary protraction with skeletal anchorage and pterygomaxillary separation. Two titanium mini-plates were placed in the lateral region of the nasal cavity and used as anchorage for maxillary protraction with a reverse-pull facemask. Pterygomaxillary separation was also performed to enhance the effects of maxillary protraction. One week after surgery, 300 g of force was applied on each side to protract the maxilla. Active treatment time was 4 months, with 12 additional months of follow-up. Analysis of the cone beam computed tomography images demonstrated that skeletal anchorage enabled the correction of the maxillomandibular discrepancy, with an improvement in facial appearance and occlusion and with no dental effects. Pterygomaxillary separation was not effective, showing no superior orthopedic response on maxillary advancement or restrictions to maxillary growth in the 12-month post-treatment follow-up.
authors.affiliation: *Department of Orthodontics †Department of Oral and Maxillofacial Surgery ‡Orthodontic Program, Pontificial Catholic University of Rio Grande do Sul (PUCRS), Partenon §Department of Oral and Maxillofacial Surgery, Center University Unichristus, Fortaleza, Brazil.
authors.forename: Luciane Macedo
authors.initials: LM
authors.lastname: de Menezes
authors.forename: Rogério Belle
authors.initials: RB
authors.lastname: de Oliveira
authors.forename: André
authors.initials: A
authors.lastname: Weissheimer
authors.forename: Rafael Linard
authors.initials: RL
authors.lastname: Avelar
mesh_terms: D001860:Bone Plates; D002508:Cephalometry / Q000379:methods; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery*; D008844:Micrognathism / Q000628:therapy; D009296:Nasal Cavity / Q000601:surgery*; D052280:Orthodontic Anchorage Procedures / Q000379:methods*; D010155:Palatal Expansion Technique; D056739:Pterygopalatine Fossa / Q000601:surgery*; D053441:Suture Anchors