Transverse maxillary deficiency requires surgical maxillary expansion when the midpalatal suture is closed. The midline osteotomy of the maxilla can lead to significant dental, gingival and bone complications. Technically, this osteotomy is usually performed using osteotomes, a burr or an oscillating saw, but is increasingly being replaced by piezosurgery. There are no published studies on the impact of piezoelectric devices on complications.

This study tries to evaluate complications after median inter-incisors osteotomy (gingival recession, tooth loss, bone loss) with piezosurgery, and then to compare them with complications associated with osteotomes.

A single-center retrospective study of 57 patients who underwent surgical maxillary expansion was conducted. Dental complications (mobility, color and loss), gingival and papilla recession and bone defect were assessed before and at least 6 months after surgery. Two groups were compared: the piezosurgery P group (49 patients) and the osteotomes O group (8 patients).

In piezosurgery group, 16.3 % of patients developed central papilla recession and 8 % bone defect, against 12.5 % and 0 % respectively in osteotomes group. No statistically significant difference was found between both groups in the incidence of gingival or bone complications.