Assessment of Maxillary Expansion by Piezocision-Assisted Orthodontics: A Pilot Study

The correction of transverse malocclusions due to maxillary width deficiency in adults is challenging. Multiple surgical and nonsurgical procedures have been used in conjunction with orthodontics to address this situation, and most common is the surgically assisted rapid maxillary expansion (SA-RME). Although successful, it is quite aggressive. The present investigation assesses the usefulness of Piezocision-assisted orthodontics as a less-invasive option for treatment of transverse maxillary deficiencies in adults. Dental casts were taken before and after Piezocision-assisted palatal expansion in four patients. They were digitized into STL files and superimposed. Differences on cross-arch tooth torque, angulation/tipping, and movement distances between time points were quantified using a digital static and a novel digital 3D-movement evaluation method. For the buccolingual movement per tooth, first premolars averaged 3.33 ± 1.3 mm, second premolars averaged 3.63 ± 0.6 mm, and first and second molars averaged 1.56 ± 1.2 mm and 0.36 ± 1.2 mm, respectively. Bodily movement of the teeth was observed with minimal tipping and no development of gingival recessions. Piezocision-assisted palatal expansion is a safe and reliable procedure that can help patients with maxillary width deficiency. It is a new tool in the orthodontist's armamentarium that can be used as an accelerator of treatment and as a new way to solve orthodontic challenges in selected adult patients.