J Korean Assoc Oral Maxillofac Surg.  2015 Apr;41(2):97-101. 10.5125/jkaoms.2015.41.2.97.

Salvage rapid maxillary expansion for the relapse of maxillary transverse expansion after Le Fort I with parasagittal osteotomy

• Lee HW
• Kim SJ
• Kwon YD

• KMID: 2189473
• DOI: http://doi.org/10.5125/jkaoms.2015.41.2.97

Abstract

Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case.

Keyword

Maxillary transverse deficiency; Le Fort osteotomy; Maxillary expansion; Salvage therapy

MeSH Terms

Congenital Abnormalities
Follow-Up Studies
Humans
Osteotomy*
Osteotomy, Le Fort
Palatal Expansion Technique*
Recurrence*
Salvage Therapy

Figure

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  Fig. 1 Intraoral photos and radiographs (cephalometric and posteroanterior view) at the initial visit. We observed a maxilla with a narrow, high vault palate, maxillary bilateral crossbite, and teeth crowding through the relatively narrow maxilla compared to the mandible.

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  Fig. 2 Preoperative intraoral photos showing the narrow palate. Transverse expansion was expected.

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  Fig. 3 Immediate postoperative radiographs.

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  Fig. 4 Removal of the surgical wafer precipitated immediate transverse relapse, and the surgical wafer was trimmed out in the constricted side to allow re-expansion.

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  Fig. 5 Fixative plates in the constricted side of the maxilla were removed and an rapid palatal expansion (RPE) was placed. After RPE placed (A), activation (B), and transpalatal arch for retention (C).

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  Fig. 6 Transverse relapse was resolved.

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  Fig. 7 Retention period (20 months after debonding). Expanded maxillary arch was maintained.

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