Journal of Cranio-Maxillofacial Surgery
Volume 38, Issue 3, April 2010, Pages 160-165

Osteogenic uni- or bilateral form of the guided rapid maxillary expansion

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K. Al-Ouf^{1, ,} , Head of the Oral and Maxillofacial Surgery Unit, C. Krenkel²,

Professor and Head of Oral and Maxillofacial Surgery Department, M.Y. Hajeer³, Senior Lecturer in

Orthodontics and S. Sakka³, Senior Lecturer in Oral and Maxillofacial Surgery

¹ Central Police Hospital, Damascus, Syria

² Paracelsus University, Muellner Hauptstr 48, 5020 Salzburg, Austria

³ University of Albaath Dental School, Hamah, Syria

Received 9 November 2008; 

accepted 28 March 2009. 

Available online 17 May 2009.

Summary

Surgically assisted rapid palatal expansion is an important treatment procedure in patients with constricted maxillae. Several surgical methods have been proposed to expand the maxilla bilaterally. A new technique was developed for performing a symmetric or asymmetric maxillary expansion guided by the stability of the mid-palatal area employing two osteotomy cuts on either side of mid-palatal suture. A Hyrax-type expansion device was used post-operatively. Seventeen patients were included in the study (9 males, 8 females) with a mean age of 30.7 years. Inter-canine and inter-molar widths were evaluated at three assessment intervals: before treatment (T1), immediately after appliance removal (T2) and at six months follow-up (T3). Between T1 and T2, a mean expansion of 7.1 and 9.9 mm was achieved at the canine and molar areas, respectively. The amount of relapse measured between T2 and T3 was minimal (a mean value of 0.35 and 0.8 mm at the canine and molar areas, respectively). Asymmetric expansion was performed in 6 patients who exhibited unilateral skeletal constriction at the initial assessment and these cases appeared stable at T3. The surgical approach described in the current study enabled rapid maxillary expansion of unilateral and bilateral skeletal constriction cases effectively and with good stability.

Keywords: rapid maxillary expansion; palatal osteogenesis; asymmetric expansion

Article Outline

Introduction

Materials and methods

Subjects

OUF-RME surgical technique

Assessment method

Results

Discussion

Conclusion

References

Fig. 1. Frontal view showing the lines of osteotomies on the maxillary complex.

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Fig. 2. Occlusal view of the maxillary complex showing the bilateral osteotomies extending from the midpoint between the upper lateral and the canine (on the right side) and between the upper central and lateral incisor (on the left side). These osteotomies are extended to the posterior border of the maxillary complex.

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Fig. 3. Lateral views. A – right view, B – left view. The lateral osteotomy line extends from the lower margin of the pirifrom aperture of the nasal cavity towards the posterior margin of the maxillary complex.

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Fig. 4. This intra-oral photograph shows the OUF-RME lines of osteotomies in the anterior region of the maxilla. It can be seen that two vertical osteotomies extend from the horizontal osteotomies towards the interdental alveoli between the central and lateral incisors bilaterally.

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