Surgical maxillary expansion: a new minimally invasive technique

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Surgical Innovation

Background:

• Traditional surgical maxillary expansion often involves significant soft tissue dissection.
• Understanding the biomechanics of palatal suture resistance is crucial for effective expansion.

Purpose of the Study:

• To describe and evaluate a minimally invasive surgical technique for maxillary expansion.
• To assess the efficacy and safety of using a 2 mm osteotome for maxillary osteotomy.
• To review literature on suture resistance during maxillary expansion and present clinical observations.

Main Methods:

• A minimally invasive surgical technique employing a 2 mm osteotome was utilized, avoiding extensive mucoperiosteal incisions.
• Twenty-four surgical osteotomy cases for maxillary expansion were performed between 1992 and 1995.
• Literature review on theories of suture resistance and personal clinical experience were incorporated.

Main Results:

• Successful maxillary expansion was achieved in 23 out of 24 cases (95.8%) using the minimally invasive technique.
• The technique demonstrated reduced trauma and invasiveness compared to traditional methods.
• The maxillary midline suture was found to be less critical for expansion resistance than the zygomatic-maxillary and pterygoid-palatine sutures.

Conclusions:

• The described 2 mm osteotome technique offers a less traumatic and effective approach to surgical maxillary expansion.
• The technique is adaptable, allowing conversion to a traditional procedure if necessary during surgery.
• Clinical experience suggests the zygomatic-maxillary and pterygoid-palatine sutures are key resistance points in maxillary expansion.