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Am J Orthod Dentofacial Orthop. 2015 Jul;148(1):138-53. doi: 10.1016/j.ajodo.2014.08.023.

Corticotomy-assisted rapid maxillary expansion: A novel approach with a 3-year follow-up.

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Private practice, Casablanca, Morocco. Electronic address:
Private practice, Casablanca, Morocco.
Specialist in orthodontics, Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dentistry, University of Hassan II, Casablanca, Morocco.
Associate professor and chair, Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea.


This case report introduces a new approach of corticotomy-assisted rapid maxillary expansion for treating a severe maxillary transverse discrepancy in a skeletally mature patient. This approach uses piezo-bone perforation in conjunction with a fixed appliance and an expander. This report describes the treatment of a 14-year-old girl with a severe maxillary transverse discrepancy. She had a straight profile, severe maxillary crowding, a maxillomandibular transverse differential index of 9 mm, and a Class I skeletal relationship. The treatment protocol consisted of surgical intervention with piezo-bone perforation and active orthodontic therapy. Immediately after the piezo-bone perforation on the lateral buccal side of the maxilla, active orthodontic therapy was started with activation of an expander. The expander was reactivated weekly. Treatment duration was 5 months 2 weeks. Proper overbite and overjet, facial balance, and occlusion were achieved. The treatment outcome was stable at the 3-year follow up. This treatment approach considerably reduced the treatment time and gained bony volume. Additionally, it transformed the periodontal biotype in contrast to conventional therapy. This approach is a good alternative for treating a severe maxillary transverse discrepancy in a skeletally mature patient, especially for a patient who does not want surgical rapid palatal expansion.

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