Orthopaedic vs surgical palatal expansion

AIM OF THE WORK. Rapid palatal expansion is the treatment of choice for skeletal cross-bite; it can be orthopaedic or surgically assisted. The purpose of this study was to evaluate three-dimensional skeletal changes in nongrowing patients who underwent surgically assisted maxillary expansion, and to compare these results with those obtained in growing patients treated by orthopaedic disjunction. MATERIALS AND METHODS. Two groups of patients with posterior cross-bite were analysed: the first group was formed by 6 adults, the second by 18 growing subjects. Lateral and frontal cephalometric x-ray films, dental casts and intraoral photographs were taken for each patient before and after expansion. RESULTS. The results showed that maxillary transversal size, nasal cavity, lower and upper arch width increased in both groups after expansion while no significant vertical change was noted at the end of treatment. ANB angle tended to increase in skeletal Classes III but it remain unchanged in Class I and II malocclusions. CONCLUSIONS. Orthopaedic rapid palatal expansion, in growing subjects, and surgically assisted palatal expansion, in adults, can be considered the best treatment for skeletal cross-bite, independently of skeletal Class and vertical relationships. Skeletal Class II and skeletal open bite malocclusions cannot be considered an absolute contraindication to palatal expansion.