Surgically assisted orthopedic expansion Osteotomy of sutures will enhance the orthopedic force. RME screw should be placed immediately after osteotomy to get good expansion of the palate. Midpalatal incision to open the interlocked suture involves considerable risk of wound dehiscence following surgery because the soft tissue over the suture is quite thin and not well vascularized. As an alternative, the osteotomy of lateral buttress of the maxilla was proposed to reduce resistance from this area.
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