Abstract
Transverse deficiency of the maxilla (TDM) is the most common skeletal change that involves the maxilla. The craniofacial skeletal assessment as early as possible is critical, as the early diagnosis of TDM influences the effectiveness of treatment. Methods for treating TDM have been reported since the mid-19th century and continue to evolve. This article puts forward a literature review on the topic, investigating the diagnosis and management of TDM, as well as stability after surgical and nonsurgical interventions. We conducted a literature search using a logical combination of the terms “palatal extension,” “maxillary transverse deficiency,” “diagnosis,” and “management.” More recent approaches include three-dimensional imaging, which has allowed for accurate depictions of the craniofacial region to be examined, allowing for evaluation of the spatial relationships between the jaw elements. The success of nonsurgical management compared to surgical management depends on the growth stage of the patient. Unfortunately, data comparing the stability of surgical and nonsurgical management is still lacking. However, for surgical intervention, surgically assisted palatal expansion (SARPE) appears to be the appropriate choice, especially when a large expansion is needed.
Highlights
BackgroundThere are three classifications of skeletal changes that involve the maxilla: vertical, horizontal, and transverse
This article puts forward a literature review on the topic, examining the diagnosis and management of TDM, as well as stability after surgical and nonsurgical interventions
Adult patients who exhibit skeletal transverse deficiency may need tooth movement that extends further than the alveolar bony base of the maxilla. This can result in anchor teeth tipping, extrusion, root resorption, alveolar bone bending, periodontal membrane compression, relapse, fenestration of the buccal cortex, palatal tissue necrosis, pain, inability to open the midpalatal suture, and expansion instability [22, 48,49,50,51,52,53,54,55,56,57,58,59]
Summary
There are three classifications of skeletal changes that involve the maxilla: vertical, horizontal, and transverse. A maxillomandibular transverse differential index greater than 5mm in an adult patient indicates that surgical expansion is necessary This method quantifies the total discrepancy, it allows for a determination of which jaw is excessive or deficient. Adult patients who exhibit skeletal transverse deficiency may need tooth movement that extends further than the alveolar bony base of the maxilla This can result in anchor teeth tipping, extrusion, root resorption, alveolar bone bending, periodontal membrane compression, relapse, fenestration of the buccal cortex, palatal tissue necrosis, pain, inability to open the midpalatal suture, and expansion instability [22, 48,49,50,51,52,53,54,55,56,57,58,59]. It appears that literature about TDM is still limited, and more studies addressing this topic are needed
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