Abstract
Maxillary constriction is a common skeletal craniofacial abnormality, and transverse maxillary deficiency affects 30% of patients receiving orthodontic and surgical treatment. The aim of the study was to analyse craniofacial skeletal changes in adults with maxillary constriction after transpalatal distraction. The study group consisted of 36 patients (16 women) aged 17 to 42 years (M = 27.1; SD = 7.8) with a known complete skeletal crossbite and who underwent transpalatal distraction procedure. The measurements were obtained on diagnostic models, and cephalometric PA radiograms were obtained at time points, i.e., before treatment (T1) and after the completion of active distraction (T2). The analysis of diagnostic models involving the arch width measurement at different levels demonstrated a significant increase in L1, L2, L3, L4, L5, and L6 dimensions after transpalatal distraction. The largest width increase (9.5 mm) was observed for the L3 dimension (the intercanine distance). The analysis of frontal cephalograms displayed a significant increase in W1, W2, and W3 dimensions after transpalatal distraction. The largest width increase (4.9 mm) was observed for the W1 dimension at the level of the alveolar process of the maxilla. Transpalatal distraction is an effective treatment for transverse maxillary deficiency after the end of bone growth. The expansion observed on diagnostic models is close to a parallel segment shift mechanism, with a mild tendency towards a larger opening anteriorly. The maxillary segment rotation pattern analysed based on the frontal cephalograms is close to a hand fan unfolding with the rotation point at the frontonasal suture.
Highlights
Maxillary constriction is a common skeletal craniofacial abnormality. 30% of patients receiving any complex orthodontic and surgical treatment suffer from transverse maxillary deficiency [1]. e appropriate transverse dimension of the upper arch ensures stable occlusion and significantly affects facial proportions and aesthetics [2, 3]
Materials and Methods e study group consisted of 36 patients (16 women) aged 16 to 49 years (M 27.1; SD 7.8) with a known complete skeletal crossbite and who underwent a transpalatal distraction procedure
E analysis of diagnostic models involving the arch width measurement at different levels demonstrated a significant increase in L1, L2, L3, L4, L5, and L6 dimensions after transpalatal distraction in patients with transverse maxillary deficiency
Summary
Maxillary constriction is a common skeletal craniofacial abnormality. 30% of patients receiving any complex orthodontic and surgical treatment suffer from transverse maxillary deficiency [1]. e appropriate transverse dimension of the upper arch ensures stable occlusion and significantly affects facial proportions and aesthetics [2, 3]. All measurements were taken on diagnostic models cast using the conventional method at two time points: before treatment (T1) and after the completion of active distraction (T2). Additional measurement of the b2, b3, b4, b5, and b6 distances was aimed at graphic presentation of maxillary expansion on the diagnostic models (Figure 2).
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