Abstract

Minimally Invasive Treatment of Transverse Maxillary Deficiency in Adults

by De Gabriele Renzo

While RPE is considered the gold standard in management of maxillary transverse deficiency in growing individuals, there are some unwanted dental side effects such buccal tipping of the anchorage teeth, alveolar bone fenestration, root resorption and gingival recession. With more mature patients such as young adults and adults the resistance to expansion increases significantly due to maturation of the MPS as well as resistance of the circummaxillary sutures and the more mature facial bones. The use of Bone-Anchored Maxillary Expander (BAME) is then recommended in those patients to increase the skeletal effects and reduce the dental side effects. However, with more mature patients the MPS may be fused and SARPE is then required. SARPE is an invasive surgical procedure with many documented complications. In addition, it is usually performed under a general anesthetic and requires complete disjunction of the maxillary bone. The goal of my presentation is to introduce a novel minimally invasive method for treating transverse maxillary deficiency in adult patients. This method involves the use of a bone borne Quadexpander appliance combined with an osteotomy of the mid-palatal suture (MPS), performed via sonosurgery. I'll describe the stepwise protocol for digital planning for miniscrew placement, fabrication of surgical guides and the minimally invasive sonosurgery procedure to release the mid palatal suture and reduce the resistance to expansion.This minimally invasive technique offers a promising alternative for adult patients providing effective expansion and reduced risk of complications and increased predictability.

Learning Objectives

After this lecture, you will be able to define specific expansion protocols in the maxillary expansion of adults
After this lecture, you will be able to evaluate the benefits of guided computer positioning in the Bone First approach
After this lecture, you will be able to increase the predictability of treatment in adult with a minimally invasive