Zusammenfassung
Der Schmalkiefer, auch Mikromaxillie, kann als Teil eines Fehlbisses unterschiedlich
korrigiert werden. Die Erweiterung erfolgt je nach Alter der Patienten mit verschiedenen
Methoden. Während bei Kindern und Jugendlichen die Verbreiterung konservativ mit Dehnplatten
erfolgen kann (rapid palatal expansion = RPE) ist dies bei Erwachsenen mit abgeschlossener
Verknöcherung nicht mehr möglich, sondern muss chirurgisch unterstützt erfolgen. In
beiden Fällen wird die Expansion mit Dehnplatten durchgeführt. Die ersten Dehnplatten
wurden bereits im 18. Jahrhundert entwickelt. Die chirurgisch unterstützte Erweiterung
(Surgically assisted rapid palatal expansion = SARPE) ist seit der ersten Hälfte
des 20. Jahrhunderts möglich. Die angewandte Methode wird durch die Verknöcherung
der Sutura palatina bestimmt, wobei diese früher als Hauptwiderstand galt. Die heutigen
Erkenntnisse haben gezeigt, dass die Resistenz im Bereich der Crista zygomatico-maxillaris
und des Processus pterygoideus mit zunehmendem Alter den Hauptwiderstand bilden.
Diesem Umstand Rechnung tragend, hat sich die Methode der chirurgischen Erweiterung
gewandelt.
Abstract
Many possible treatment modalities exist for correction of maxillary transverse width
discrepancies. Opening of the midpalatal suture with expansion appliances was used
in children and young adults to widen a deficient maxilla in the nineteenth century.
This marks the beginning of rapid palatal expansion (RPE). Surgically assisted rapid
palatal expansion (SARPE) was introduced in the first half of the last century as
conservative treatment of maxillary deficiency in adults was not successful. Historically
the midpalatal suture was thought to be the area of resistance to expansion. However,
studies have shown that the facial skeleton increases its resistance to expansion
as it ages and that the major site of resistance are zygomatic-maxillary buttress
and pterygopalatinal process. Therefore SARPE is a useful technique for maxillary
deficiency in adults.
Schlüsselwörter
Gaumennahterweiterung - Expansion - transversale Diskrepanz - SARPE
Key words
rapid maxillary expansion - expansion - transverse discrepancy - SARPE
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Prim. Univ. Prof. Dr. I. M. Watzke
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