Susami T, Kuroda T, Amagasa T
Department of Oral Surgery, University of Tokyo, Japan.
Cleft Palate Craniofac J. 1996 Sep;33(5):445-9. doi: 10.1597/1545-1569_1996_033_0445_otoacp_2.3.co_2.
Some adult cleft palate patients show severe maxillary transverse contraction and posterior crossbite. This case report demonstrates successful surgical-orthodontic treatment of such a patient. Surgically assisted rapid maxillary expansion (SA-RME) was completed prior to comprehensive orthodontic treatment. The osteotomy was performed on both the buccal and lingual aspects of the posterior maxillary alveolus. A Hyrax-type maxillary-expansion appliance was used, and the screw (0.2 mm, one quarter turn) was turned two or three times per day. Comprehensive orthodontic treatment was initiated after extraction of the mandibular first premolars and four third molars. The maxillary lateral incisors were also extracted after active orthodontic treatment. The amount of expansion achieved using SA-RME was greater at the posterior than at the anterior maxilla. Midpalatal suture opening occurred. After orthodontic treatment, occlusal stability was satisfactory. This case demonstrates the effectiveness of SA-RME in adult cleft palate patients with severe posterior crossbite.
一些成年腭裂患者表现出严重的上颌横向收缩和后牙反合。本病例报告展示了对一名此类患者成功进行的外科正畸治疗。在全面正畸治疗之前完成了外科辅助快速上颌扩弓（SA-RME）。在上颌后牙槽的颊侧和舌侧均进行了截骨术。使用了Hyrax型上颌扩弓矫治器，每天将螺丝（0.2毫米，四分之一圈）旋转两到三次。在下颌第一前磨牙和四颗第三磨牙拔除后开始全面正畸治疗。在积极正畸治疗后也拔除了上颌侧切牙。使用SA-RME实现的扩弓量在上颌后部大于前部。腭中缝打开。正畸治疗后，咬合稳定性令人满意。本病例证明了SA-RME在患有严重后牙反合的成年腭裂患者中的有效性。
