Informationen aus Orthodontie & Kieferorthopädie 2016; 48(04): 271-277
DOI: 10.1055/s-0042-121348
Fallbericht
© Georg Thieme Verlag KG Stuttgart · New York

Aktueller Stand der operativen Techniken zur chirurgisch gestützten Gaumennahterweiterung

Surgical Correction of Transversal Deficits in the Maxilla: Current State of Surgical Techniques for Surgically Assisted Maxillary Expansion
R. Seeberger
1   Praxis für Mund-, Kiefer-, Gesichts- und Oralchirurgie, Ludwigsburg
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Publikationsverlauf

Publikationsdatum:
04. Januar 2017 (online)

Zusammenfassung

Patienten mit einer skelettal bedingten Dysgnathie haben häufig auch ein transversales Defizit des Oberkiefers. Ein-oder beidseitiger Kreuzbiss, ein enges und hohes Gaumendach sowie Zahnengstände sind dabei typische klinische Charakteristika. Diese gehen dann mit kaufunktionellen, atemspezifischen und ästhetischen Beeinträchtigungen einher. Die Therapie beinhaltet in skelettal reifen Patienten eine chirurgische Expansion der Maxilla. Aktuell existieren verschiedene operative Techniken und konkurrierende Expansionsapparaturen in der Therapie dieser Fehlstellungen. Neben der chirurgisch unterstützen Gaumennahterweiterung, die in unterschiedlichen Techniken ausgeführt werden kann, ist auch eine einzeitige Lösung mit Expansion der Maxilla im Rahmen der eigentlichen Umstellungsosteotomie eine vielversprechende Alternative. Im Folgenden werden die operativen Schritte zur Erweiterung des Oberkiefers anhand klinischer Beispiele demonstriert und in Hinblick auf die aktuelle Literatur kritisch diskutiert.

Abstract

Patients with a skeletal-related malocclusion often have a transversal deficit of the upper jaw at the same time. A 1- or 2-sided cross bite, a narrow and high palate and crowded teeth are typical clinical characteristics. They are associated with masticatory, respiratory and aesthetic impairments. Therapy involves surgical expansion of the maxilla in skeletally mature patients. Currently there are various surgical techniques and competing expansion devices for treating these occlusal deficits. In addition to the surgically supported palatal expansion, which can be executed in different techniques, a one-step solution is a promising alternative by expanding the maxilla within the actual orthognathic surgery. In the following the surgical steps for the expansion of the upper jaw are demonstrated by clinical examples and critically discussed with regard to the current literature.

 
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