Relapse and Stability of Surgically Assisted Rapid Maxillary Expansion: An Anatomic Biomechanical Study

Koudstaal, Maarten J.; Smeets, Jeroen B.J.; Kleinrensink, Gert-Jan; Schulten, Alcuin J.M.; van der Wal, Karel G.H.

doi:10.1016/j.joms.2007.11.026

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 1 , Pages 10-14, January 2009

Relapse and Stability of Surgically Assisted Rapid Maxillary Expansion: An Anatomic Biomechanical Study

Maarten J. Koudstaal, MD
- Resident-Trainee, Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Address correspondence and reprint requests to Dr Koudstaal: Department of Oral and Maxillofacial Surgery, Erasmus University, Medical Center Rotterdam, ‵s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
Jeroen B.J. Smeets, PhD
- Professor, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands
Gert-Jan Kleinrensink, MD, PhD
- Doctor, Department of Neurosciences and Anatomy, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
Alcuin J.M. Schulten, DDS, PhD
- Orthodontist, Department of Orthodontics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
Karel G.H. van der Wal, MD, PhD, DDS
- Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands

Purpose

This anatomic biomechanical study was undertaken to gain insight into the underlining mechanism of tipping of the maxillary segments during transverse expansion using tooth-borne and bone-borne distraction devices.

Materials and Methods

An anatomic biomechanical study was performed on 10 dentate human cadaver heads using tooth-borne and bone-borne distraction devices.

Results

The amount of tipping of the maxillary halves was greater in the tooth-borne group, but the difference was not significant. Four of the specimens demonstrated an asymmetrical widening of the maxilla.

Conclusions

Segmental tipping was seen in both study groups. In this anatomic model, tooth-borne distraction led to greater segmental tipping compared with bone-borne distraction. Keep in mind, however, that this anatomic model by no means depicts a patient situation, and any extrapolation from it must be done with great care. The fact that the tooth-borne group demonstrated greater tipping might reflect the general opinion that bone-borne distraction causes less segmental angulation than tooth-borne distraction. Some tipping was seen in the bone-borne group, suggesting that overcorrection to counteract relapse will be necessary with this treatment modality.