Complications following surgically assisted maxillary expansion
Complicações após expansão de maxila cirurgicamente assistida
Albuquerque, Gustavo Cavalcanti; Gonçales, Andréa Guedes Barreto; Neto, Victor Tieghi; Nogueira, Alexandre Simões; Assis, Diogo Souza Ferreira Rubim de; Gonçales, Eduardo Sanches
http://dx.doi.org/10.1590/S1807-25772013000100004
Rev. odontol. UNESP, vol.42, n1, p.20-24, 2013
Abstract
The treatment of adult transverse maxillary deficiency is the surgically assisted maxillary expansion. Several surgical techniques have been described for this and complications have been related to these procedures. Objective: the aim of this study was evaluate the incidence of complications associated with surgically assisted maxillary expansion. Material and method: 33 individuals undergone surgically assisted maxillary expansion by subtotal Le Fort I osteotomy with a step in the zygomatic-maxillary buttress and associated to pterigomaxillary disjunction and osteotomy of intermaxillary suture. Operative complications, post-operative complications and the distance between the upper teeth were recorded. Result: 12 men and 21 women with an average age of 24.64 years undergone the procedure. The interdental distances increased from preoperative to 2 months post‑operative time. The prevalent complications were sinusitis (6%) and teeth displacement and inclination (6%). Conclusion: Surgically assisted maxillary expansion is an effective and low morbidity procedure to treat transverse maxillary deficiency in adults.
Keywords
Palatal expansion, osteotomy, postoperative complication.
Resumo
O tratamento da deficiência transversal de maxila, em adultos, exige a expansão de maxila cirurgicamente assistida. Diversas técnicas cirúrgicas são conhecidas para a realização desse procedimento, porém estas relacionam-se com complicações. Objetivo: Avaliar a incidência de complicações associadas ao procedimento de expansão de maxila cirurgicamente assistida. Material e método: Trinta e três indivíduos com deficiência transversal de maxila foram submetidos ao procedimento de expansão pela técnica da osteotomia Le Fort I subtotal com degrau no pilar zigomático-maxilar, disjunção ptérigo-maxilar e osteotomia da sutura intermaxilar. Durante os períodos trans e pós-operatório, as complicações relacionadas ao procedimento e as distâncias interdentais foram registradas. Resultado: Doze homens e 21 mulheres, com idade média de 24,64 anos, submeteram-se ao procedimento. As mensurações das distâncias interdentais evidenciaram aumento das mesmas entre os períodos pré-operatório e pós-operatório de 2 meses. As complicações prevalentes foram sinusite (6%) e deslocamento associado à inclinação dental (6%). Conclusão: A expansão de maxila cirurgicamente assistida é um procedimento eficaz e de baixa morbidade para o tratamento da deficiência transversal de maxila em indivíduos adultos.
Palavras-chave
Expansão palatina, osteotomia, complicações pós-operatórias.
Referências
1. Gonçales ES, Polido WD. Tratamento ortodôntico-cirúrgico de deficiência transversal de maxila: conceitos para o cirurgião bucomaxilofacial e relato de caso. Rev Inst Ciências Saúde. 1998;16(1):55-9.
2. Betts NJ, Vanarsdall RL, Barber HD, Higgins-Barber K, Fonseca RJ. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthod Orthognath Surg. 1995;10(2):75-96. PMid:9082002.
3. Bishara SE, Staley RN. Maxillary expansion: clinical implications. Am J Orthod Dentofac Orthop.1987;91:3-14. http://dx.doi.org/10.1016/0889-5406(87)90202-2
4. Phillips C, Medland WH, Fields HW, Proffit WR, White RP. Stability of surgical maxillary expansion. Int J Adult Orthognath Surg.1992;7:139-46.
5. Bell WH, Epker BN. Surgical-orthodontic expansion of the maxilla. Am J Orthod. 1976;70:517-28. http://dx.doi.org/10.1016/0002-9416(76)90276-1
6. Glassman AS, Nahigian SJ, Medway J, Aronowitz HI. Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases. Am J Orthod. 1984;86:207-13. http://dx.doi.org/10.1016/0002-9416(84)90372-5
7. Schwarz GM, Trash, WJ, Byrd DL, Jacobs, JD. Tomographic assesment of nasal septal changes following surgical-orthodontic rapid maxillary expansion. Am J Orthod. 1985;87:39-45. http://dx.doi.org/10.1016/0002-9416(85)90172-1
8. Bays RA, Greco JM. Surgically assisted rapid palatal expansion: an outpatient technique with long - term stability. J Oral Maxillofac Surg. 1992;50:110-13. http://dx.doi.org/10.1016/0278-2391(92)90352-Z
9. Basdra EK, Zoller JE, Komposh G. Surgically assisted rapid palatal expansion. J Clin Prosthod. 1995;29:762-6.
10. Woods M, Wisenfeld D, Probert T. Surgically-assisted maxillary expansion. Aust Dent J. 1997;42:38-42. PMid:9078645. http://dx.doi.org/10.1111/j.1834-7819.1997.tb00094.x
11. Antilla A, Finne K, Keski-Nisula K, Somppi M, Panula K, Peltomaki T. Feseability and long-term stability of surgically assisted rapid maxillay expansion with lateral osteotomy. Eur J Orthod.2004;26:391-5. http://dx.doi.org/10.1093/ejo/26.4.391
12. Cureton SL, Cuenin M. Surgically assisted rapid palatal expansion: orthodonthic preparation for clinical sucess. Am J Orthod Dentofacial Orthop. 1999;116:46-59. http://dx.doi.org/10.1016/S0889-5406(99)70302-1
13. Schimming R, Feller KU, Herzmann K, Eckelt U. Surgical and orthodontic rapid palatal expansion in adults using Glassman's technique: retrospective study. Br J Oral Maxillofac Surg.2000;38:66-9. PMid:10783452. http://dx.doi.org/10.1054/bjom.1999.0274
14. Lanigan DT, Mintz SM. Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case. J Oral Maxillofac Surg. 2002;60:104-10. http://dx.doi.org/10.1053/joms.2002.29087
15. Chung CH, Goldman AM. Dental tipping and rotation immediately after surgically assisted rapid palatal expansion. Eur J Orthod. 2004;25:353-8. http://dx.doi.org/10.1093/ejo/25.4.353
16. Chuah C, Mehra P. Bilateral lingual anesthesia following surgically assisted rapid palatal expansion: report of a case. J Oral Maxillofac Surg. 2005;63:416-8. PMid:15742300. http://dx.doi.org/10.1016/j.joms.2004.03.021
17. Verlinden CR, Gooris PG, Becking AG. Complications in transpalatal distraction osteogenesis: a retrospective clinical study. J Oral Maxillofac Surg. 2011;69:899-905. PMid:21236540. http://dx.doi.org/10.1016/j.joms.2010.11.026
18. Williams BJ, Currimbhoy S, Silva A, O'Ryan FS. Complications following surgically assisted rapid palatal expansion: a retrospective cohort study. J Oral Maxillofac Surg. 2012;70(10):2394-402. PMid:22516838. http://dx.doi.org/10.1016/j.joms.2011.09.050
19. Gonçales ES, Assis DR, Capelozza ALA, Alvares LC. Estudo radiográfico digital indireto do efeito da expansão de maxila cirurgicamente assistida (EMCA) sobre o septo nasal. Rev Dental Press Ortodon Ortoped Facial. 2007;12:85-91. http://dx.doi.org/10.1590/S1415-54192007000500011
20. Assis DSFR, Duarte MA, Gonçales ES. Clinical evaluation of the alar base width of patients submitted to surgically assisted maxillary expansion. Oral Maxillofac Surg. 2010;14:149-54. PMid:20306321. http://dx.doi.org/10.1007/s10006-010-0211-3
21. Assis DSFR, Ribeiro Júnior PD, Duarte MAH, Gonçales ES. Evaluation of the mesio-bucal gingival sulcus depth of the upper central incisors in patients submitted to surgically assisted maxillary expansion. Oral Maxillofac Surg. 2011;15:79-84. PMid:20526638. http://dx.doi.org/10.1007/s10006-010-0233-x
22. Starnbach H, Bayne D, Cleall J, Subtelny JD. Facioskeletal and dental changes resulting from rapid maxillary expansion. Angle Orthod. 1966;36:152-64. PMid:4956318.
23. Capelozza L Filho, Cardoso J Neto, Silva OG, Ursi WJS. Non-surgically assisted rapid maxillary expansion in adults. Int J Adult Orthod Orthognath Surg.1996;11:57-66.
24. Ferreira FV. Ortodontia: diagnóstico e planejamento clínico. São Paulo: Artes Médicas; 2008.
25. Politis C. Life-threatening haemorrhage after 750 Le Fort I osteotomies and 376 SARPE procedures. Int J Oral Maxillofac Surg. 2012;41:702-8. PMid:22480877. http://dx.doi.org/10.1016/j.ijom.2012.02.015
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email