Unilateral and bilateral corticotomies for correction of maxillary transverse discrepancies

Surgically-assisted rapid maxillary expansion in adults has been proved effective in overcoming the strong resistance of the maxillary complex after growth is completed, particularly after the second decade of life. The aim of this study was to describe the dental and the skeletal expansion and relapse, as well as the amount of tipping of the two maxillary bones and first permanent molars, during a rapid maxillary expansion procedure combined with unilateral and bilateral corticotomies. The sample consisted of four adult patients, two presenting with bilateral and two with unilateral cross-bite. Records were taken before and after rapid maxillary expansion, at the end of retention and at least 12 months post-retention. In the cases of bilateral cross-bite the same amount of skeletal expansion was observed on both sides. The angular changes measured at the upper first molars indicated important tipping on both sides, which tended to relapse moderately during the retention and post-retention period. Following unilateral surgery, the operated side showed more than twice the amount of skeletal expansion than the non-operated side. The angular changes presented twice as much tipping and relapse on the operated side. The results of this study demonstrate that unilateral cross-bites in adults can be corrected with unilateral corticotomy and rapid maxillary expansion using the contralateral non-operated side as anchorage. Stability appeared satisfactory in all cases.