Abstract
Objective
This study aimed to evaluate the long-term stability of surgical maxillary expansion using patient-specific fixation implants (PSFIs) without intraoral retention.
Materials and methods
Fifteen patients who had undergone segmented Le Fort I osteotomy and PSFIs with available preoperative (t0) early (t1) and 1-year follow-up computed tomography (CT) scans (t2) were evaluated. The early and 1-year 3D models were superimposed to transfer the bony landmarks; the distances between each pair of landmarks at the different time points were then measured. The distances between the canines and second molars were also measured directly on the CT scans.
Results
The achieved maxillary expansions ranged from a median of 4.39 (2.00–6.27) mm at the greater palatine foramina to a median of 2.14 (1.56–2 > 83) mm at the canine level of the palatal bone. One year postoperatively, the changes in skeletal diameters ranged from a median of − 0.53 (− 1.65 to 0.41) mm at the greater palatine foramina (p = 0.12) to 0.17 (− 0.09 to 0.32) mm at the canine level of the palatal bone (p = 0.56). Changes in dental arch diameters ranged from a median of − 0.6 (− 2 to 0.00) mm between the second molars to − 1.3 (− 1.8 to − 0.25) mm between the canines (P < 0.05).
Conclusion
This study showed the stability of maxillary expansion osteotomy using PSFIs, even without postoperative intraoral retention.
Clinical relevance
PSFIs are a reliable method for the surgical treatment of transverse maxillary discrepancy. PFSIs are easy-to-use and improve surgical accuracy.
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Acknowledgements
The authors would like to thank Guillaume Dubois and Mathieu Charles at Materialise Medical France (Malakoff, France) for providing a Mimics Suite licence and support in performing the measurements. We also thank the orthodontist, Laure Guittard, for her collaboration with this article, especially for the clinical analysis of occlusion stability.
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This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.
Dr Thomas Schouman is a consultant for Materialise. Dr Thomas Schouman and Pr. Patrick Goudot are co-inventors of the SynpliciTi. The other authors declare no financial disclosures or conflicts of interest.
The Institutional Review Board that approved the study was the Research Ethics Committee of Sorbonne University. (Approval N°: CER-2020–101).
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Galli, P., Foy, JP., Le Roux, MK. et al. Stability of maxillary expansion osteotomy using patient-specific fixation implants without necessitating removable appliances: a retrospective analysis. Clin Oral Invest 27, 3393–3403 (2023). https://doi.org/10.1007/s00784-023-05082-3
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DOI: https://doi.org/10.1007/s00784-023-05082-3