One-Step Surgical Correction of Transverse and Anteroposterior Maxillary Deficiencies Using Wire Fixation. A New Approach and Long-Term Stability
| Autor: | Max Domingues Pereira, Lydia Masako Ferreira, Vivian Farfel, Gabriela Pereira Ribeiro Prado |
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| Rok vydání: | 2016 |
| Předmět: |
Molar
Adult Male Palatal Expansion Technique Time Factors Hyrax Radiography Dentistry 03 medical and health sciences 0302 clinical medicine medicine Maxilla Humans Retrospective Studies Fibrous joint biology business.industry Soft tissue 030206 dentistry biology.organism_classification Cementoenamel junction medicine.anatomical_structure Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Surgery Nasion Oral Surgery business Bone Wires Follow-Up Studies |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 75(7) |
| ISSN: | 1531-5053 |
| Popis: | To describe a retrospective assessment of the long-term stability of a new approach using wire fixation for 1-step surgical correction of transverse and anteroposterior maxillary deficiencies.The authors implemented a case series of 5 adult patients (3 men and 2 women; mean age, 31.4 yr) needing maxillary advancement less than 5 mm and had transverse maxillary deficiency greater than 7 mm who underwent total Le Fort I and median palatal suture osteotomies and had their maxilla advanced and stabilized bilaterally with stainless steel wire. Transverse expansion was performed using a Hyrax expander, which also was used for retention for 4 months after completion of the planned expansion. Follow-up included clinical examination and studies of lateral radiographs and plaster models preoperatively (T0), soon after completion of maxillary expansion (T1), 4 months after T1 (T2), 12 months after T1 (T3), and an average of 4.8 years (minimum, 4 yr 1 month; maximum, 5 yr; standard deviation, 0.3 yr) after T1 (T4).Maxillary expansions measured at the most cervical points on the palatal face of the upper first premolars and of the upper first molars at T2 were 7.8 and 7.4 mm on average, respectively. In all cases, surgery promoted maxillary anteroposterior advancement. Anteroposterior maxillary skeletal measurements of the angle formed by the sella, nasion, and A point; the distance from the vertical reference line to the A point (A-VRL); the distance of the VRL to the cementoenamel junction (CEJ); and the distance from the perpendicular line of the nasion (Nperp) to the CEJ showed a substantially increase at T1 (P .05) and stability at T2, T3, and T4; however, A-VRL presented a significant relapse at T4 compared with T1 (P = .037) and T2 (P = .027). The soft tissues expanded at the same rate as the skeletal tissues. The anteroposterior soft tissue measurements Nperp to superior lip and Nperp to the A' point showed a substantial increase at T2 (P .05) and stability at T3 and T4. The measurements associated with anteroposterior correction were stable at T4.The proposed technique provides long-term stability of maxillary expansion and anteroposterior repositioning with only 1 surgical intervention. However, considering the small number of patients, a multicenter study is needed before a definitive conclusion can be reached. |
| Databáze: | OpenAIRE |
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