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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2003 April;14(1):23-9
A new transpalatal distractor device. Report of 3 cases with surgical and occlusal evaluations
Cortese A., De Cristofaro M., Papa F., Savastano G.
Maxillofacial Surgery Division Department of Oral and Maxillofacial Surgery “Federico II” University of Naples, Naples
Aim. This report presents a new transpalatal distractor device (TDD) and analyses the change in the maxillary resulting from applying the distractor in 3 adult patients affected by severe palatal constriction.
Methods. The TDD was made of a Rematitan titanium expansion screw (Dentaurum, Italy) welded with 2 titanium miniplates (Leibinger, Germany). The device was applied by four 8 mm screws, and activated 0.20 mm 4 times a day. Following distraction the expansion screws were blocked for 4 months. The intermolar, interpremolar, and intercanine distances were obtained before the TDD appliance, 1 week and 4 months after activation so as to evaluate increases in maxillary width. To measure changes in the angulation in the frontal plane, the intermolar and interpremolar angle variations were taken too.
Results. There was an increase of the arch perimeter, which correlated well with the expansion at dental level, resulting in teeth crowding resolution. The changes in the angulation tooth in the frontal plane were minimal, indicating a mainly skeletal movement.
Conclusion. Tooth movement could be the major reason for relapse after expansion treatment for transpalatal distraction. The device used, mainly produced a skeletal movement, as the force was directly applied to the palatal bone, and there was only a minimal angulation of tooth movements.