Estabilidade esquelética transversal utilizando arco transpalatal e aparelho ortodôntico fixo após expansão rápida da maxila assistida cirurgicamente (ERMAC)

• Autor(a) principal: Sato, Ylri Hirokatsu [UNIFESP]
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://hdl.handle.net/11600/70901
• topic: Anormalidades maxilomandibulares; Anormalidades craniofaciais; Desenvolvimento maxilofacial; Técnica de expansão palataina

Introduction: Surgically assisted rapid maxillary expansion is considered one of the most unstable surgical procedures in the scale of the stability hierarchy of craniofacial surgeries. There is still no consensus in the literature as to whether or not to use forms of retention, such as the transpalatal arch and fixed orthodontic appliances, after the expansion period, with the aim of increasing the stability of this procedure. Objective: To evaluate the effect of transpalatal arch retainers and fixed orthodontic appliances on the skeletal stability of patients undergoing surgically assisted rapid maxillary expansion. Methods: Sixty-five patients were evaluated, using digitized plaster models, at pre-expansion moments, four and ten months after completion of expansion. Patients were divided into four groups: group without fixed orthodontic appliances and without retainer (CASC); without fixed orthodontic appliances and with retention (SACC); with fixed orthodontic appliance and without restraint (CASC); with fixed orthodontic appliance and with retention (CACC). The variables evaluated were the area, volume and height of the palate, intercervical molar and intercervical premolar distance. Results: The area and volume, premolar and molar intercervical distance showed an increase from preoperative to four months in all groups, but palate height showed a decrease in all groups. Between the fourth and tenth month after completion of the expansion, it was possible to observe that in the three-dimensional variables, area and volume of the palate, there was a reduction in the values obtained, however, with no difference between the groups. As for the height of the palate, no variation. The intercervical molar and premolar distance showed differences between the groups, and the groups that did not use the transpalatal arch retainer showed greater reductions than those that did not. Conclusion: the transpalatal arch, the fixed orthodontic appliance or the combination of the two, have no effect on the stability of the area, volume and height of the palate. The transpalatal arch increases the stability of the premolar and molar intercervical distances. The transpalatal arch, the fixed orthodontic appliance or the combination of the two has no clinical relevance to stability in surgically assisted rapid maxillary expansion.