Complications of surgically assisted rapid palatal expansion: Review of the literature and report of a case

Lanigan, Dennis T.; Mintz, Sheldon

doi:10.1053/joms.2002.29087

Cited by 118 publications

(90 citation statements)

References 18 publications

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“…Rare symptoms that have been reported following SARME, such as temporary partial paralysis of the oculomotor nerve [23] and bilateral lingual anesthesia [24], were not observed in our study.…”

Section: Discussioncontrasting

confidence: 66%

“…However, the surgery is not free of risks and complications that have been reported in the literature include infection, hemorrhage, periodontal problems, devitalization of teeth, pain and neurological sequelae [3,22,23]. Complications may also arise due to the expansion appliance, including breakage or loosening of the appliance, stripping or locking of the screw and impingement of the palatal soft tissue causing tissue necrosis [24].…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment of maxillary transverse deficiency: retrospective study of 14 patients

Milani

Müller

Brunetto

et al. 2009

J. Maxillofac. Oral Surg.

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Introduction The diversity of the proposed techniques in the treatment of maxillary transverse deficiency in adults reflects the conflicting opinions about the primary area of resistance to maxillary expansion in the craniofacial skeleton. In order to evaluate the efficiency of the surgical expansion in which no osteotomies of the pterygomaxillary junction were made, we have carried out a retrospective study with 14 patients with maxillary transverse deficiency, who were treated from 2003 to 2006. Material and methods In the study, models were made prior to and after surgery, and the intercanine and intermolar distances and the improvement of the interocclusal relationships were analyzed. Breathing function and the complications that occurred during and after the surgeries were also analyzed. Results All expansions were carried out according to pre-surgical planning so that expansion completely corrected the crossbite, resulting in the desired final occlusion for all patients. Intraoperative complications were limited to one Hyrax appliance deformation. Two patients had minor postoperative complications that included wound dehiscence and pain. Improvements in nasal breathing were observed in all patients that complained of breathing problems prior to the surgery. Conclusion The satisfactory results obtained turns the surgical protocol described in this study recommended for the treatment of maxillary transverse deficiency in adults. Importantly, we found that pterygomaxillary osteotomy is not essential for maxillary expansion. The morbidity of the procedure was low with fairly minor complications, and surgically assisted rapid maxillary expansion was shown to improve nasal breathing.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Surgical treatment of maxillary transverse deficiency: retrospective study of 14 patients

Milani

Müller

Brunetto

et al. 2009

J. Maxillofac. Oral Surg.

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“…Haas 19 reports that pressure is generated by the alveolar processes, palatal vault, maxilla articulations (frontomaxillary, nasomaxillary, zygomaticomaxillary sutures), and zygomaticotemporal regions. Lines 20 attributed the pressure to frontomaxillary, zygomaticotemporal, zygomaticofrontal, and zygomaticomaxillary sutures; Timms 1 suspected the midpalatal suture and Revelo and Fishman 21 suspected zygomatic area and maxillary articulations, while Shetty et al 22 and Lanigan and Mintz 23 named the midpalatal and pterygomaxillary sutures as the major buttresses.…”

Section: Discussionmentioning

confidence: 99%

Hounsfield Units: A new indicator showing maxillary resistance in rapid maxillary expansion cases?

Acar

Motro

Erverdi

2015

The Angle Orthodontist

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Objective: To determine if density measurements of several maxillary regions in Hounsfield Units (HU) and outcomes of rapid maxillary expansion (RME) are correlated. Is correlation powerful enough to give us direct information about maxillary resistance to RME? Materials and Methods: Twenty-two computed tomographic (CT) scans (14 years) are used in this archive study. Two CT records were collected, one before RME (T 1 ) and one after 3 months of retention period (T 2 ). Maxillary measurements were made using dental and skeletal landmarks in first molar and first premolar slides to measure the effects of RME. Density of midpalatal suture (MPSD) and segments of maxillary bone is measured in HU at T 1 . Correlation analysis was conducted between density measurements and maxillary variables. Regression analysis was then performed for variables that showed positive correlation. Results: There was no correlation between density and skeletal measurements. Intermolar angle (ImA) in molar slice showed statistically significant correlation with density measurements. The ImA variable showed the highest correlation with MPSD in frontal section (r 5 0.669, P , .01). Conclusions: There is correlation of 32.1-43.3% between density measurements and ImA increase. Our density measurements explain a certain percentage of ImA increase, but density is not the only and definitive indicator of changes after RME. (Angle Orthod. 2015;85:109-116.)

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“…6,21 However, it may cause severe complications. 4,22 There is controversy with regard to which age is required for SARME, since many authors [23][24][25] have shown successful nonsurgical RME in adults as well. Therefore, finding a congruent diagnostic procedure to indicate SARME is essential but not yet possible.…”

Section: Resultsmentioning

confidence: 99%

“…1,2 To date, the decision of whether to use surgically assisted RME (SARME) has been an age-based one, although no reliable correlation between chronological age and changes in the midpalatal suture in skeletally mature patients exists. 3 Since SARME results in a higher morbidity than conventional RME, 4,5 finding ways to determine if and to what extend the expansion of the maxillary complex will need surgical assistance or not is important to reducing the potential risks for the patient. 6 A decrease in the midpalatal suture width, which can be age and functional related, [7][8][9] is a potential prognostic factor for an increase of the resistance against conventional RME.…”

Section: Introductionmentioning

confidence: 99%

Measurement of the midpalatal suture width

Fricke-Zech

Gruber

Dullin

et al. 2011

The Angle Orthodontist

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Objective: To conduct a pilot study to investigate the potentiality to determine the midpalatal sutural width radiographically with a flat-panel volume computed tomography (fpVCT) in a porcine model. Materials and Methods: Bone samples from the midpalatal suture of five young (16 weeks) and five old (200 weeks) sus scrofa domestica were gathered. The midpalatal suture width was measured via fpVCT and compared to respective histological preparations. Results with P , .05 were considered significant.

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Complications of surgically assisted rapid palatal expansion: Review of the literature and report of a case

Cited by 118 publications

References 18 publications

Surgical treatment of maxillary transverse deficiency: retrospective study of 14 patients

Surgical treatment of maxillary transverse deficiency: retrospective study of 14 patients

Hounsfield Units: A new indicator showing maxillary resistance in rapid maxillary expansion cases?

Measurement of the midpalatal suture width

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