الفهرس 
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Abstract
It was designed to evaluate dento-alveolar changes occurred after corticotomy assisted slow palatal expansion in patients with maxillary constriction.
The present study was carried on 16 patients (4 males and 12 females) who needed maxillary expansion as a part of their comprehensive orthodontic treatment, the patients of this study selected from the outpatient clinic of the orthodontic department; Faculty of dentistry-Suez Canal University, with mean age 19 years ranging from 14- 24 years without any congenital anomalies in the craniofacial structures.
The patients divided into 2 groups:
A. First group (control non-corticotomized group): included 6 patients who did not subjected to alveolar corticotomy before maxillary expansion.
B. Second group (experimental corticotomy group): included 10 patients who subjected to alveolar corticotomy 1 week before maxillary expansion.
A Cone Beam Computed Tomography (CBCT) radiographs before and immediately after expansion and the following data was analyzed:
A. Linear measurements
1. Intermolar width (IMW): this was measured as a straight line joining the mesiobuccal cusps tips of the first molars on 3D reconstructed occlusal image at T1 and T2 to evaluate the efficiency of SME in both groups.
2. Interpremolar width (IPW): this was measured as a straight line joining the buccal cusps tips of first premolars on 3D reconstructed occlusal image T1 and T2 to evaluate the efficiency of SME in both groups.
3. Buccal bone thickness (BBT): measurements of the maxillary first molars and first premolars were measured from root surface to the outer most margin of buccal bone at the level of their trifurcation and bifurcation points respectively at T1 and T2 to evaluate the change in BBT after SME in both groups.
B. Angular measurements
1. Root angulation: buccolingually, root torque (of molars and premolars) to midsagital plane (plane connecting midpalatal suture and nasal septum) at T1 and T2 to evaluate the effect of SME on dental tipping in both groups.
2. Crown tipping: this was measured as a line connecting buccal and lingual cusps to midsagital plane (plane connecting midpalatal suture and nasal septum) at T1 and T2 to evaluate the effect of SME on dental tipping in both groups.
The following conclusions could be drawn from the current study:
1. For both control and corticotomy groups SME efficiently caused maxillary expansion.
2. Arch widths (IMW and IPmW) increased in both groups but it was more significant in corrticotomy group.
3. Buccal bone thickness of all teeth attached to the appliance decreased significantly in both groups, and there were no significant difference in BBT change between corticotomy and control group.
4. Dental tipping: increase of tooth tipping (root angulation and crown angulation) happened in both groups it was significant in molars and premolars in corticotomy groups, and significant only in premolars of control group, and change in all angulations between corticotomy and control groups were not significant.
Suggestions for further investigations:
1. To apply the corticotomy assisted expansion technique over a larger sample of patients and for longer follow up periods after removal of orthodontic appliance.
2. To study the effect of this technique if corticotomy done in buccal and palatal cortical bones.
3. To evaluate the stability and relapse tendency of this technique.
4. To evaluate the change in buccal bone thickness after removal of the appliance and possibility of bone regeneration.
5. To study the effect and need of bone graft accompanying this technique.
6. To study the skeletal effects of this technique on maxilla, circummaxillary structures and mandible