Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지

CLINICAL STUDY OF SURGICALLY ASSISTED RAPID MAXILLARY EXPANSION

외과적 술식을 동반한 급속 상악 확장술의 임상 연구

  • Yang, Chan-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University) ;
  • Min, Seung-Ki (Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University) ;
  • Oh, Sung-Hwang (Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University) ;
  • Kwon, Kyung-Hwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University) ;
  • Lee, Jun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University) ;
  • Cha, Jae-Won (Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University)
  • 양찬영 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 민승기 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 오승환 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 권경환 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 이준 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 차재원 (원광대학교 치과대학 구강악안면외과학교실)
  • Published : 2005.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Orthopedic rapid maxillary expansion(RME) has been a common treatment modality used to widen narrow maxillae in young children. However, since more skeletally matured adolescents or adults has closed midpalatal suture, the result of RME was undesirable because of dental tipping with little or no basal skeletal movement and resulted to many other complications. After such treatment, complications often occurred such as alveolar bending, compression of periodontal ligament, extrusion, buccal tipping, and severe relapse. Thus, surgically assisted rapid maxillary expansion(SA-RME) is required, especially for patients over 14 years old, to skeletally release maxillary expansion. We used two methods of maxillary expansion surgery. Surgically assisted rapid maxillary expansion(SA-RME) & surgically assisted posterior segmental expansion(SA-PSE) were used for narrow maxilla. The study was divided into two groups(SA-RME group and SA-PSE group). SA-RME group was consisted of 2 males and 4 females, and the ages of materials ranged from 15 years to 25 years with a mean of 20.2 years. SA-PSE group was consisted of 1 male and 5 females, and the ages ranged from 13 years to 23 years with a mean of 18.7 years. Dental study models were fabricated before starting the expansion and immediately after the expansion was completed. It was fabricated again 1 month later, 3 months later when the expansion device was removed, and 6 months later after the expansion was completed. A repeated measures analysis of variance(ANOVA) test was applied to assess changes between each groups over time. The amount of expansion and the amount of tipping movement each in both groups were compared by using paired t-test and it was also compared between each subjects within the group by using independent t-test. Both SA-RME and SA-PSE group showed stable results, but SA-PSE group showed statical significance in tipping movement of second premolar. We compared 6 patients who recieved SA-RME with 6 patients who received SA-PSE, and appraised the clinical usefulness.

Keywords

References

  1. Angell EH : Treatment of irregularities of the permanent or adult tooth. Dental Cosmos 1860;1:540
  2. Haas AJ : Rapid palatal expansion of the maxillary dental arch and nasal cavity by opening the midfacial suture. Angle Orthod 1961; 31:73
  3. Brown VGI : The surgery of oral and facial disease and malformation, 4th edn. London. Kimptom : 507, 1938
  4. Starnbach H, Bayne DI : Fascioskeletal and dental changes resulting from rapid expansion. Angle Orthod 1966;36:152
  5. Mommaerts MY : Transpalatal distraction as a method of maxillary expansion. Br J Oral Maxillofac Surg 1999;37:268 https://doi.org/10.1054/bjom.1999.0127
  6. Leslie AC : Slow maxillary expansion : Skeletal versus dental relaps to low magnitude force in Macaca mulatta. Am J Orthod 1978;73:1
  7. Hershey HG : Changes in nasal airway resistance associated with rapid maxillary expansion. Am J Orthod 1976;39:274
  8. Isaacson RJ, Murphy TD : Some effects of rapid maxillary expansion in cleft lip and palate patients. Angle Orthod 1964;34:143
  9. Moss JP : Rapid expansion of the maxillary arch. I. Int J Pract Orthod 1968;2:165
  10. Moss JP : Rapid expansion of the maxillary arch. II. Int J Pract Orthod 1968;2:215
  11. Barber AF, Sims MR : Rapid maxillary expansion and external root resorption in man : a scanning electron microscope study. Am J Orthod 1981;79:630 https://doi.org/10.1016/0002-9416(81)90356-0
  12. Langford SR : Root resorption extreme resulting from clinical RME. Am J Orthod 1982;81:371 https://doi.org/10.1016/0002-9416(82)90074-4
  13. Haas AJ : Long-term post operative treatment evaluation of rapid palatal expansion. Angle Orthod 1980;50:189
  14. Isaacson RJ : Forced produced by rapid maxillary expansion. Angle Orthod 1969;34:256
  15. Lines PA : Adult rapid maxillary expansion with corticotomy. Am J Orthod 1975;67:44
  16. Bell WH, Jacobs JD : Surgical-orthodontic correction of horizontal maxillary deficiency. J Oral Surg 1979;37:897
  17. Wertz RA : Skeletal and dental changes accompanied by rapid midpalatal suture opening. Am J Orthod 1970;58:41
  18. Steinhauser EW : The midline-splitting of maxillar for correction of malocclusion. J Oral Surg 1972;30:413
  19. Kennedy JW, Bell WH : Osteotomy as an adjunct to rapid maxillary expansion. Am J Orthod 1976;70:123 https://doi.org/10.1016/S0002-9416(76)90313-4
  20. Timms DJ : The relationship of rapid maxillary expansion to surgery, with special reference to midpalatal synostosis. Br J Oral Surg 1981;19:180 https://doi.org/10.1016/0007-117X(81)90003-2
  21. Glassman AS, Nahigian SJ : Conservative surgical orthodontic adult rapid palatal expansion : sixteen cases. Am J Orthod 1984;86:207 https://doi.org/10.1016/0002-9416(84)90372-5
  22. Schimming R, Feller KU, Herzmann K : Surgical and orthodontic rapid palatal expansion in adults using Glassman's technique : retrospective study. Br J Oral Maxillofac Surg 2000;38:66
  23. Bays RA, Greco JM : Surgically assisted rapid palatal expansion : an outpatient technique with long-term stability. J Oral Maxillofac Surg 1992;50:110
  24. Bell WH. Epker BN : Surgical-orthodontic expansion of the maxilla. Am J Orthod 1976;70:517
  25. Bashara SE, Staley RN : Maxillary expansion : clinical implications. Am J Orthod Dentofac Orthop 1987;91:3
  26. Lassman AS, Nahigian SJ : Conservative surgical orthodontic adult rapid palatal expansion : sixteen cases. Am J Orthod 1984;86:207 https://doi.org/10.1016/0002-9416(84)90372-5
  27. Kraut RA : Surgically assisted rapid maxillary expansion by opening the midpalatal suture. J Oral Maxillofac Surg 1984;42:651 https://doi.org/10.1016/0278-2391(84)90207-6
  28. Jacobs JD, Bell WH, Williams CE : Control of the transverse dimension with surgery and orthodontics. Am J Orthod 1980;77:284 https://doi.org/10.1016/0002-9416(80)90083-4
  29. Lanigan DT : Complications of surgically assisted rapid palatal expansion : review of the literature and report of a case. J Oral Maxillofac Surg 2002;60:104 https://doi.org/10.1053/joms.2002.29087
  30. Block MS, Cervini D, Chang A : Anterior maxillary advancement using tooth-supported distraction osteogenesis. J Oral Maxillofac Surg 1995;53:561
  31. Matteini C, Mommaerts MY : Posterior transpalatal distraction with pterygoid disjunction. A short-term model study. Am J Orthod Dentofac Orthop 2001;120:498
  32. Lehman JA, Haas AJ : Surgical-orthodontic correction of transvers maxillary deficiency. Dent Clin North Am 1990;34:385
  33. Alpern MC, Yurosko JJ : Rapid palatal expansion in adults with and without surgery. Angle Orthod 1987;57:245
  34. Mehra P, Cottrell DA, Caiszzo A : Life-threatening delayed epistaxis after surgically assisted rapid palatal expansion : A case report. J Oral Maxillofac Surg 1999;57:201
  35. Li KK, Meara JG, Rubin PA : Orbital compartment syndrome following orthognathic surgery. J Oral Maxillofac Surg 1995;53:964 https://doi.org/10.1016/0278-2391(95)90294-5
  36. Steven LC : Surgically assisted rapid palatal expansion : Orthodontic preparation for clinical success. Am J Orthod Dentofac Orthop 1999; 116:46
  37. Mustafa O : Pulpal blood flow. effect of corticotomy and midline osteotomy in surgically assisted rapid palatal expansion. J Craniomaxillofac Surg 2003;31:97 https://doi.org/10.1016/S1010-5182(03)00039-8
  38. Biederman W : Rapid correction of class III malocclusion by midpalatal expansion. Am J Orthod 1973;63:47
  39. Stromberg C : Surgically assisted rapid maxillary expansion in adults. A retrospective long-term follow up study. J Craniomaxillofac Surg 1995;23:222