Technical note
Direct Bone Placement of the Hyrax Fixation Screw for Surgically Assisted Rapid Palatal Expansion (SARPE)

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Subjects and Methods

For the pilot study in man, 2 female patients aged 21 and 23 years were treated presurgically. Both showed severe crossbite and Class III malocclusion. A hyrax screw with a maximum expansion of 12 mm was used. For the direct bone fixation with minimum surgical intervention, 1 implant and 1 bone screw were used. The extraoral implant with supraperiosteal step (EO ID 4 mm – Ti; Straumann, Basel, Switzerland), a length of 4 mm, and a 3.5 mm neck with a 5 mm head was applied for fixation of the

Results

After an expansion of 8 mm, the hyrax screw with the osteosynthesis screw on 1 side of the implant was removed. The implant was then used for fixation of the palatal bar to prevent relapse and to provide anchorage (Fig 5).

The 8-mm expansion was achieved after 21 and 40 days in each of the 2 patients, respectively (Fig 6). Orthognathic surgery was continued after retention and a 6-month bone rehabilitation period. The palatal bar with implant fixation remained. The expansion was guided

Discussion

There is no higher risk for the patient with the new method because the insertion of orthodontic implants is a routine procedure. There is no sign of inflammation, bone loss, or damage in the region of implant insertion after RPE. The 2-point fixation in combination with the sectional wire guidance in the incisor region is sufficient for RPE in adult patients with presurgical osteotomy. This procedure is minimally invasive and effective because it is combined with the osteotomy during the same

Acknowledgment

The authors thank Straumann, Europe (Basel, Switzerland) for supplying the EO-implants.

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Received from the University Clinics, Technical University of Dresden, Dresden, Germany.

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