Patient C. C., female, 22 years, Class I
malocclusion
sharp posterior cross bite on the right side and mild
the left, masked by the diversion of mandibular midline,
addition to upper right lateral incisor slightly crowded,
ogival palate, jaw and oral hygiene atresia satisfactory. In
analysis of models, was diagnosed disability cross
absolute of the maxilla (Figures 1 and 2).
sharp posterior cross bite on the right side and mild
the left, masked by the diversion of mandibular midline,
addition to upper right lateral incisor slightly crowded,
ogival palate, jaw and oral hygiene atresia satisfactory. In
analysis of models, was diagnosed disability cross
absolute of the maxilla (Figures 1 and 2).
Figures 1 Models of plaster which is
observed posterior cross bite
Figures 2 intra-oral preoperative
The treatment
plan was proposed an interaction-orthodontic surgery, which required the
installation of the orthodontist
maxillary expander apparatus for subsequent completion of the procedure
surgery. After cementation of orthodontic device
the upper teeth, was a radiography for occlusal
evaluation of the median palatine suture and a panoramic radiograph,
where were the dental structures, the positioning
root of upper central incisor and the
pterigomaxilares processes with the adjacent teeth.
maxillary expander apparatus for subsequent completion of the procedure
surgery. After cementation of orthodontic device
the upper teeth, was a radiography for occlusal
evaluation of the median palatine suture and a panoramic radiograph,
where were the dental structures, the positioning
root of upper central incisor and the
pterigomaxilares processes with the adjacent teeth.
Figures 3 Exposure of the lateral wall of the maxillary
Figures 4 Osteotomy of
the Le Fort I type out and release the areas of resistance the maxilla. Note the trans-operative
diastema.
Figures 5 Control of
postoperative 3 months, which is observed descruzamento bite and the closure of inter-incisor
diastema by action of periodontal fibers.
completion of tooth movement at this stage of treatment.
After verification of laboratory tests , the patient underwent the surgical procedure,
under general anesthesia, according to the technique described above
(Figures 3 and 4). On the first day after surgery the patient
received condition of hospital discharge, with controls postoperative
outpatients and performed targeted to active day-tions of the apparatus of a fourth expander back in the morning and the same procedure in the night from the third day postoperatively.
After 17 days of activations the desired expansion was achieved.
The expander device
was maintained for 3 months and then removed and installed the palatal plate, which should be 3 to 6 months, leading below for the installation of fixed equipment and conventional
completion of tooth movement (Figures 5 and 6). In this when the patient is in preparation for orthodontic
correction of mandibular midline deviation of the technique of sagittal osteotomy of mandibular branch
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