An Analysis of Early Changes to the Craniofacial Skeleton Induced by Transpalatal Distraction in a Patient with Maxillary Constriction, Based on Computed Tomography Scans – Case Report

摘要

Abstract Transpalatal distraction is a recognized surgical treatment of transverse maxillary deficiency in adult patients. In skeletally mature individuals, rapid maxillary expansion (RME) is ineffective or leads to dental and periodontal complications. Transpalatal distraction works on the principle of distraction osteogenesis, increasing the maxillary base width and its transverse dimensions. Skeletal expansion of the maxilla will lead to an increase in the volume of the nasal cavity with proper conversion of the nasal breathing track. The increase in width of the maxilla will also overcome the unsightly dark corridors during a smile. The clinical manifestation of the maxillary expansion during active distraction treatment is the emergence of diastema between the maxillary central incisors. Currently available diagnostic imaging techniques such as computed tomography (CT) and 3D image reconstruction of craniofacial bone structure enable precise analysis of active treatment. The paper presents the case of a 29-year-old woman with maxillary constriction and skeletal class III malocclusion, treated with transpalatal distraction. The changes in maxillofacial complex were quantified based on the selected axial computed tomography scans taken before and after the end of active treatment. Furthermore, a 3D reconstruction of the craniofacial skeleton was performed so as to obtain a realistic picture of TPD-induced changes.