Surgically-assisted maxillary expansion

A combined surgical and orthodontic technique for management of transverse maxillary deficiencies in mature patients is described and discussed. Special references are made to the surgical release of several circummaxillary articulations to facilitate the use of a fixed expansion device, and to the authors' addition of an osteotomy below the nasal spine, to ensure that the nasal septum remains independent of the maxillary segments. Indications for the use of this surgically-assisted maxillary expansion technique, and its advantages when compared with segmented surgical expansion, are also presented.