Surgically Assisted Rapid Palatal Expansion Using Piezosurgery - Case Report

When planning orthodontic treatment in young adult patients with substantial maxillary stenosis, there are indications for combined surgical and orthodontic treatment. These are difficult patients for whom only orthodontic maxillary expansion would involve a risk of vestibular protrusion or extrusion of the posterior teeth, fenestration in bone lamella, inability to open palatal suture or a tendency to recurrences upon completion of the treatment. The aim of surgically assisted rapid palatal expansion (SARPE) procedure is to overcome the bone resistance to the maxillary expansion device. Ultrasonic bone cutting techniques (piezosurgery), used so far with great success as they enable selective tissue cutting, appear to be particularly useful for those surgical procedures which involve a risk of damaging important anatomic structures. Maxillary cortical osteotomy using a piezosurgical device was performed in a patient with substantial stenosis of upper dental arch within the bone base accompanied by bilateral cross bite. After nine months a significant maxillary expansion and no cross bite were observed. Piezosurgery used for osteotomy in the maxillary lateral segment enabled microinvasive operation with minimal risk of damage to the maxillary sinusal mucosa