SURGICALLY ASSISTED PALATAL EXPANSION

Surgically assisted palatal expansion, also called rapid palatal expansion, is a common orthognathic procedure that can be done on individuals of any age. (J Oral Maxillofac Surg 72:2278-2288, 2014). In the younger patient it involves just a loosening of the structures. In the teen and older patient I typically do a complete osteotomy as it is not a particularly invasive procedure, our patients do well with a quick recovery (usually outpatient), and with low risk.

There are 2 basic techniques or patterns that we follow and these depending upon the bite. The first of these is a midline osteotomy which means separating the upper jaw down the center of the palate to widen it. The other is called a paramedian separation which is usually right behind the lateral incisor teeth or eye teeth and then separation down the palate. All of this is done through the mouth and just through a small incision under the upper lip and gums. This is a procedure that is done in concert with the orthodontist who manages the dental movements during the healing process using the palatal appliance as shown. Basically, we are making small cuts in what are thin bones and then very slowly (orthopedically) moving the bone, teeth, and tissue during the bone healing process. This improves the jaw position and actually adds your own bone and tissue to the jaw in the process. This is a procedure we have done for over thirty years with good results.