Modificações crânio-maxilares resultantes da expansão rápida da maxila em adultos, cirurgicamente assistida ou apoiada em mini-implantes associados a cirurgias minimamente invasivas

Abstract

Maxilary transverse discrepancy is the horizontal disharmony between the Maxilla and the Mandible. During a long time, surgical expansion (SARPE) was the only option available to correct transverse discrepancy in adult patients. Recently, miniscrew assisted rapid palatal expansion slightly increased the age ranges which don’t need to undergo surgery. In skeletal mature patients, conservative osteotomes performed at ambulatory have been proposed to simplify the surgical technique, associated with a mini-screw supported expander (MISMARPE). A retrospective study with CBCT scans of previously treated patients was performed. 44 CBCT scans of of 22 adult patients - aged between 18-56 years old - were evaluated at two moments: T0 (initial) and T1 (immediate after the expansion). The sample consisted of 2 groups: SARPE (n=11) and MISMARPE (n=11) to evaluate the skeletal and dental changes produced by this two techniques. The results observed were very similar between the two techniques. Even though not statistically significant (p<0,005), a greater inclination of the upper first molars was observed on the SARPE group, as well as a more parallel expansion was reported on the MISMARPE group. The findings indicate a possible use for MISMARPE as an ambulatory surgical approach to maxillary transverse deficiency in adult patients.