SURGICALLY ASSISTED RAPID MAXILLARY EXPANSION: CASE REPORT

Abstract

Introduction: Introduction: Maxillary atresia becomes one of the first requirements to be resolved in orthodontic planning, however, in patients who have already stopped growth, surgically assisted rapid maxillary expansion (ERMAC) has demonstrated great clinical success in the treatment of this skeletal deformity. Objective: To describe and discuss the main aspects of ERMCA through a clinical case report of a patient with severe jaw deficiency. Case Report: A 17-year-old male patient presented to the Oral and Maxillofacial Surgery and Traumatology service at the Oswaldo Cruz University Hospital of the University of Pernambuco, wanting to correct a maxillofacial deformity. During the physical examination, severe malar deficiency, lip incompetence, bilateral Class III molar and canine relationships, high palate, maxillary atresia, unilateral crossbite on the right and top on the right, anterior open bite, rotated teeth, lingualized and oral hygiene were monitored. unfavorable. The patient is recommended to undergo ERMAC and subsequently orthognathic surgery. Lefort-1 osteotomy, midpalatal division, pterygomaxillary disjunction without lower fracture was performed. The HYRAX device was cemented prior to surgery and activated transsurgically after osteotomies with two complete turns, remaining with two turns of activation during the immediate surgical procedure. Distraction began after three days of surgery. One mm of distraction per day was performed for 10 days. The patient was referred for fixed orthodontic treatment to correct anterior crowding. Follow-up was after 4 months and analyzed how skeletal relationships were in harmony. Slow crowding, anterior open bite and posterior crossbite were corrected. Conclusion: This case highlights the effectiveness and stability of ERMCA in correcting transverse maxillary discrepancies, safely and revealing excellent results, with low complications and morbidity.