Disgiunzione maxillare chirurgica: osteotomia di Le Fort I multisegmentata = Surgical maxillary expansion: segmented Le Fort I osteotomy

OBJECTIVES. The aim of this work is to present, by means of an international literature review, a complete overview of the main methods of surgical treatment in adult patients with contraction of the maxillary transverse diameters, in order to assess risks and benefits of each. MATERIALS AND METHODS. A systematic review of the international literature was conducted on MedLine database (www.ncbi.nlm.nih.gov/pubmed).The chosen keywords were: "surgical palatal expansion"; "rapid palatal expansion"; " Le Fort I osteotomy"; "crossbite"; "transverse maxillary hypoplasia". RESULTS. In adult patients, the definitive therapy consists of a surgical treatment for restoring a correct relationship between the maxillary and mandibular bones. The two main options are Surgically Assisted Rapid Palatal Expansion (SARPE) and multisegmental Le Fort I osteotomy. CONCLUSIONS. The SARPE technique seems to be the ideal treatment for the correction of isolated transverse maxillary deficiencies, including severe cases, whereas the multisegmental Le Fort I os-teotomy is useful to correct transverse de-terations on sagittal and vertical planes, thus solving the whole malocclusion in a single surgical step.