Adjustable selective maxillary expansion combined with maxillomandibular surgery: A case report

Area of Science:

• Orthognathic surgery
• Maxillofacial reconstruction
• Craniofacial anomalies

Background:

• Surgically assisted rapid maxillary expansion (SARME) is standard for adult transverse maxillary deficiency.
• Associated sagittal or vertical discrepancies often necessitate a second surgical intervention.
• This study explores novel devices for simultaneous multi-dimensional correction.

Observation:

• A case report details a 21-year-old female with skeletal Class III malocclusion, laterognathism, and transverse maxillary deficiency.
• The patient underwent a single-stage surgery utilizing sliding osteosynthesis plates and a bone-borne distractor.
• Pre-surgical orthodontics involved mandibular arch leveling and initiation of maxillary leveling 3 months prior to surgery.

Findings:

• The combined approach of sliding osteosynthesis and adjustable bone distractor successfully addressed transverse, sagittal, and vertical discrepancies in one procedure.
• Postoperative palatal distraction and orthodontic finishing achieved complete dental and bony correction within 3 months.
• The achieved correction remained stable in all dimensions at a 2-year follow-up.

Implications:

• This single-stage surgical technique offers a potentially reduced treatment duration for complex maxillofacial deformities.
• The innovative devices provide a viable alternative to multi-stage surgical interventions.
• This approach may enhance patient outcomes and reduce treatment complexity in orthognathic surgery.