The Rotterdam Palatal Distractor: introduction of the new bone-borne device and report of the pilot study

Análise da distribuição das tensões dentárias em maxila submetida a expansão cirurgicamente assistida

“…Em alguns indivíduos observaram sutura intermaxilar muito espessa, que foram então osteotomizadas, permitindo a expansão. Shetty et al (1994) As tensões produzidas pelos aparelhos expansores durante a expansão de maxila, além de significativas e de dissiparem pelos ossos da face em direção ao crânio , são transmitidas aos ossos pelos dentes de suporte do aparelho (nos aparelhos dento-suportados), pelos dentes de suporte do aparelho e pelo apoio acrílico (nos aparelhos dento-muco-suportados) (GARIB et al 2006;BRETOS et al 2007;LODDI et al 2008;HINO et al 2008) e diretamente ao osso (nos aparelhos ósseos-suportados) (RAMIERI et al 2005, GERLACH & ZAHL, 2005KOUDSTAAL et al 2006;KOUDSTAAL et al 2009a;FERNÁNDEZ-SANROMÁN et al 2010). Starnbach et al (1966) relataram que o dente de suporte movimenta-se em direção ao movimento expansivo e, segundo Bell & Epker (1976), a expansão de maxila exclusivamente ortopédica em adultos, pode empurrar os dentes lateralmente através do osso, sem abertura da sutura palatina mediana, sendo que movimentação dentária e inclinação do osso alveolar são consequências comuns dessa terapia.…”

Distraction Osteogenesis of the Maxillofacial Skeleton: Clinical and Radiological Evaluation

“…Transpalatal distraction device is a bone-borne appliance that directs the forces mainly to the palatal helves close to the center of resistance of the maxillary bone without tooth movement; it also leaves all of the crowns clear for orthodontic access (Mommaerts et al, 1999). Additionally, most of the maxillary expansion is orthopaedic (Aras et al 2011;Koudstaal et al 2006). TPDO is an effective and largely painless technique for maxillary expansion free of complications and relapses.…”

“…Moreover, the use of these appliances is not dependent on the number of anchorage teeth available. TPDO has been used extensively in the expansion of maxillary collapse in non-congenital defects (Gunbay et al 2008a;Koudstaal et al 2006;Mommaerts, 1999). Recurrence of the collapse and alveolar bone effects are among the reported complications (Gunbay et al 2008a;Mommaerts, 1999;Suri & Taneja, 2008).…”

“…Recurrence of the collapse and alveolar bone effects are among the reported complications (Gunbay et al 2008a;Mommaerts, 1999;Suri & Taneja, 2008). Transverse maxillary expansion with a bone-borne transpalatal distractor has been used with favourable results in congenital and acquired transverse maxillary deficiency (Gunbay et al 2008a;Koudstaal et al, 2006;Mommaerts, 1999;Suri & Taneja, 2008;Vyas et al 2009). In many studies, effects of transversal expansion have been examined by posteroanterior cephalometric measurements in dentoalveolar, maxillary base and nasal regions.…”

The Use of Bone-Borne Distractor for Correcting the Maxillary Transverse Discrepancy in an Adult Patient

“…Thus, to avoid such complications, many bone-borne distractors have been developed (3)(4)(5). These distractor devices are directly placed onto the palatal bone during the surgical procedure aiming to guide the applied forces and decrease the injuries caused by the expansion protocol such as: tooth inclination, root resorptions, periodontal ligament compression, fenestration of the buccal bone cortical, and severe bone resorptions (6,7).…”