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Measuring Maxillary Posterior Tooth Movement: A Model Assessment using Palatal and Dental Superimposition
Published on: February 23, 2024
Stability of surgical maxillary expansion
C Phillips1, W H Medland, H W Fields
1Department of Orthodontics, University of North Carolina, School of Dentistry, Chapel Hill 27599.
The International Journal of Adult Orthodontics and Orthognathic Surgery
|January 11, 1992
Summary
Maxillary expansion via Le Fort I osteotomy shows significant relapse, especially in molars. Overexpansion, occlusal splint use, and arch wires are recommended for stable results.
Area of Science:
- Orthognathic surgery
- Maxillofacial reconstruction
- Dental orthodontics
Background:
- Transverse expansion of the maxilla using Le Fort I osteotomy is a common procedure.
- Assessing long-term stability and relapse patterns is crucial for treatment success.
Purpose of the Study:
- To evaluate the stability and relapse of transverse maxillary expansion achieved with Le Fort I osteotomy with segments.
- To identify factors influencing postsurgical stability and relapse.
Main Methods:
- A retrospective study of 39 patients who underwent maxillary expansion via Le Fort I osteotomy with segments.
- Measurement of maxillary expansion at the second molars and first premolars.
- Analysis of postsurgical relapse and correlation with various surgical and orthodontic factors.
Main Results:
- Average expansion was 5.4 mm at molars, decreasing to 2.8 mm at premolars.
- Average relapse was 2.6 mm at molars, with 49% relapse posteriorly, decreasing to 30% at premolars.
- Significant variability in stability was observed; 75% had some relapse at first molars, but 25% were stable. Concurrent mandibular surgery increased relapse.
Conclusions:
- Maxillary expansion with Le Fort I osteotomy demonstrates considerable relapse, particularly posteriorly.
- Recommendations for improved stability include moderate overexpansion, prolonged occlusal splint use (6+ weeks), and auxiliary arch wires to maintain molar width.
