How Can We Achieve Maximum Maxilla Expansion Using the Maxillary Multi-segmentation Technique in Orthognathic Surgery?
Igor Thiago Bragatto de Mendonça *
São Leopoldo Mandic, Campinas, São Paulo, Brazil.
Andréa Juliana Luz Perdigão
Private Office in São Paulo, São Paulo, Brazil.
Marília de Oliveira Coelho Dutra Leal
Institute of Legal Medicine, Roraima, Brazil.
Renato Assis Machado
Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas and Master Program, School of Dentistry, Ingá University Center, Paraná, Brazil
Roberto Macoto Suguimoto
Private Office in São Paulo, São Paulo, Brazil.
Rubens Gonçalves Teixeira
Maxillofacial Surgery Department, São Leopoldo Mandic, Campinas, São Paulo, Brazil.
Claudio Roberto Pacheco Jodas
Maxillofacial Surgery Department, São Leopoldo Mandic, Campinas, São Paulo, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: To describe maxillary multi-segmentation technique (MMST) during orthognathic surgery illustrated through a clinical case.
Study Design: Original Research Article.
Methodology: Maxillary transverse deficiency is a complex etiological condition that can impact individuals of all ages. In patients with transverse maxillary deficiencies greater than 5 mm who have reached skeletal maturity, surgically assisted maxillary expansion (SAME) is the treatment of choice. The MMST offers an alternative for correcting dentofacial deformities in multiple planes in a surgical procedure. So, orthodontic considerations and surgical considerations were described and illustrated through a clinical case. A 42-year-old male e with dentoesqueletal deformities Class III due anterior-posterior and transverse maxillary and paranasal deficiency and anterior-posterior mandibular excess. The surgery was carried out through Le Fort I osteotomy in combination with a segmentary osteotomy and bilateral setback sagittal split osteotomy. Clinical and cone beam computed tomography post operatory controls were made during the first 3 months
Results: MMST demonstrated an excellent potential for transverse maxillary expansion of 14mm trans surgically, with preserved stability, with a three-month follow-up.
Conclusion: Our results can be considered highly stable in both the postoperative and long-term periods compared to adult patients undergoing surgically assisted maxillary expansion with tooth-borne expanders. We do not have clinical findings regarding SAME using an expander supported by the palatal bone.
Keywords: Maxillary expansion, multi-segmentation, orthognathic surgery