Em Cirurgia Ortognática, Expansão Cirúrgica da Maxila

L.C. Mariani, EB. Pagotto, L.E. Manganello-Souza, L.C. Colucci, A.R. Sanches.
International Journal of Oral and Maxillofacial Surgery
Volume 34, Supplement 1, 2005, Pages 63, October 2005, Pages 1019
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The purpose of this study was to compare and evaluate the results of two surgical techniques that can be carried through expansion to maxillary expansion surgically assisted. In a prospective study from February 2001 to November 2003, 42 surgeries had been carried through expansion to maxillary. Patients from group A (21 patients) were submitted to conservative surgical technique that consisted of bilateral osteotomies the zygomatic maxillary buttress and of midpalatal sutures. The patients from group B (21 patients) were submitted to subtotal Le Fort I osteotomy preserving the pteriogoidea suture associated with midpalatal osteotomy. All the patients (groups A and B) were submitted to the activation of 2 mm at the time of surgery. On the third postoperative day, the activation of the devices was initiated 1 mm/day shared in two times. Group A – In the 21 cases the expansion was obtained. The average of 8.5mm (variation of 6-12.5mm) of palatal expansion was reached. The mean time of activation was 7 days (5 to 18 days). We observed 3 complications in three different patients. Two cases of palatal mucosa necrosis due to Haas device compression, and one case of broken hyrax device. The changing device treated all cases. The patients were followed without any complications. Group B – In the 21 cases also the expansion was obtained as planned. The average of 7.5 mm (variation of 6-13mm) of palatal expansion was reached in a mean of 8 days (from 6 to 14 days). We observed one case of broken Hyrax device that was immediately changed without major complications. Comparing the results of the two groups (A and B) we can conclude that as much the conservative technique as Le Fort I “sub-total” can bring good results in the maxillary surgical expansion, although we prefer the conservative technique. The use of Hyrax must be preferred against of Haas due to the possibility of palatal necrosis.

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