ORIGINAL ARTICLES   

Rivista Italiana di Chirurgia Maxillo-Facciale 2003 April;14(1):23-9

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English

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.