Surgically Assisted Palatine Expansion in Adult Patients: Evaluation of a Conservative Technique

Purpose

This study was conducted to assess a conservative technique for surgically assisted palatine expansion (SAPE) done under local anesthesia and conscious sedation in adults. Dental inclination, uniformity of expansion, and satisfaction of orthodontist were evaluated.

Patients and Methods

Twenty-seven consecutive patients, ranging in age from 25 to 42 years, underwent SAPE under local anesthesia. The surgical procedure involved osteotomy of the lateral wall of the maxilla, from the maxillary tuberosity to the nasal cavity, with the nasal septum and the ptyerigoid plates left intact. Cast models were obtained before surgery and 1 year after surgery. Cuspid inclinations were assessed, with intercanine distance in 2 points, the incisal and cervical borders, measured before and after surgery. Molar inclination was obtained by measuring intermolar distance at the cervical margin and occlusal table. The results were statistically analyzed by analysis of variance. A questionnaire with 4 questions was addressed to the orthodontists to evaluate the level of satisfaction with the procedure.

Results

Cuspid and molar inclination occurred, but there was no statistically significant difference (P < .05) in dental inclination before and after surgery. The expansion was greater at the molar level than at the canine level, but this difference also was not statistically significant (P > .05). According to the questionnaire, 100% of the procedures allowed the expansion, 100% of the orthodontists were satisfied, and 68.75% observed dental inclination, but this inclination was not excessive in 100% of the cases.

Conclusions

The proposed technique is a safe, predictable, and reliable method for SAPE in adult patients. Although ptyerigoid plate and nasal septum fractures were not performed, the maxillary bone exhibited uniform expansion. Dental inclination was not significant, either clinically or during cast model analysis. Orthodontists could achieve treatment objectives with this surgical procedure.