Top

06-05-2024 | Computed Tomography | Research

Three-dimensional assessment of the maxilla after modified surgically assisted rapid expansion: a retrospective study

Authors: Felippe Almeida Costa, Marcelo Santos Bahia, Priscila Quintino Chabot, Cassio Edvard Sverzut, Alexandre Elias Trivellato

Published in: Oral and Maxillofacial Surgery

Abstract

Objective

This retrospective study aims to assess the three-dimensional dentoskeletal effects and median palatal suture opening pattern in patients undergoing modified surgically assisted maxillary rapid expansion (SARME) without pterygoid plate detachment.

Methods

Twenty-eight patients submitted to modified SARME between 2009 and 2016 were retrospectively evaluated through cone-beam computed tomography (CBCT). Dental and skeletal measurements were taken at three different operative periods (before the expansion - T0; at the end of the activation of the Hyrax device - T1; and six months after the immobilization of the device - T2). Statistical analyses, including ANOVA and Pearson’s correlation coefficient, were performed using SPSS software.

Results

SARME demonstrated significant transverse maxillary expansion (with an average of 6.05 mm) with a greater impact in the anterior region. Dental measurements, including canine and molar distances, exhibited significant changes over the operative periods. Bone measurements (ANS and PNS) presented small but significant alterations, including a slight inferior displacement of ANS during device activation. The nasal floor width increased, followed by a width reduction after immobilization. The median palatal suture predominantly exhibited a Type II (V-shaped) opening.

Conclusion

The modified SARME presented a transversal direction increase and a super-lower skeletal displacement, with the anterior region being more affected than the posterior region. There was no change in the anteroposterior direction of the maxilla. Additionally, there was an increase in the linear dental measurements and a decrease in the angular measurement, with a positive correlation between the amount of posterior bone expansion and molar expansion as a result of the treatment in the analyzed period.

Kilic E, Kilic B, Kurt G, Sakin C, Alkan A (2013) Effects of surgically assisted rapid palatal expansion with and without pterygomaxillary disjunction on dental and skeletal structures: a retrospective review. Oral Surg Oral Med Oral Pathol Oral Radiol [Internet] 115(2):167–74. https://doi.org/10.1016/j.oooo.2012.02.026

Bishara S, Staley E, Robert N (1987) Maxillary expansion: clinical implications. Am J Orthod Dentofac Orthop (1):3–14

Haas AJ (1965) The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod [Internet] 35:200–17. https://doi.org/10.1043/0003-3219(1965)035%3C0200:TTOMDB%3E2.0.CO;2

Haas AJ (1970) Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod [Internet] 57(3):219–55. https://doi.org/10.1016/0002-9416(70)90241-1

Haas AJ (1980) Long-term posttreatment evaluation of rapid palatal expansion. Angle Orthod [Internet] 50(3):189–217. https://doi.org/10.1043/0003-3219(1980)050%3C0189:LPEORP%3E2.0.CO;2

Bailey LJ, White RP Jr, Proffit WR, Turvey TA (1997) Segmental LeFort I osteotomy for management of transverse maxillary deficiency. J Oral Maxillofac Surg [Internet] 55(7):728–31. https://doi.org/10.1016/s0278-2391(97)90588-7

Betts NJ, Vanarsdall RL, Barber HD, Higgins-Barber K, Fonseca RJ (1995) Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg 10(2):75–96PubMed

Lokesh -. Suri, (2008) Taneja. Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofac Orthop (133):290–302

Iodice G, Bocchino T, Casadei M, Baldi D, Robiony M (2013) Evaluations of sagittal and vertical changes induced by surgically assisted rapid palatal expansion. J Craniofac Surg [Internet] 24(4):1210–4. https://doi.org/10.1097/SCS.0b013e3182997830

10.

Kennedy III, James W (1976) Osteotomy as an adjunct to rapid maxillary expansion. Am J Orthod (2):123–137

11.

Arat FE, Arat ZM, Tompson B, Tanju S, Erden I (2008) Muscular and condylar response to rapid maxillary expansion. Part 2: magnetic resonance imaging study of the temporomandibular joint. Am J Orthod Dentofacial Orthop [Internet] 133(6):823–9. https://doi.org/10.1016/j.ajodo.2006.07.029

12.

Baratieri C, Alves M Jr, Sant’anna EF, Nojima M da, Nojima CG (2011) LI. 3D mandibular positioning after rapid maxillary expansion in Class II malocclusion. Braz Dent J [Internet] 22(5):428–34. https://doi.org/10.1590/s0103-64402011000500014

13.

Bays RA, Greco JM (1992) Surgically assisted rapid palatal expansion: an outpatient technique with long-term stability. J Oral Maxillofac Surg [Internet] 50(2):110–3; discussion 114-5. https://doi.org/10.1016/0278-2391(92)90352-z

14.

Pereira MD, Prado GP, Abramoff MM, Aloise AC, Masako Ferreira L (2010) Classification of midpalatal suture opening after surgically assisted rapid maxillary expansion using computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(1):41–45 Epub 2010 Apr 22. PMID: 20417136CrossRefPubMed

15.

Brown GVI (1938) The surgery of oral and facial diseases and malformations: their diagnosis and treatment including plastic surgical reconstruction. Lea & Febiger

16.

Seeberger R, Kater W, Schulte-Geers M, Davids R, Freier K, Thiele O (2011) Changes after surgically-assisted maxillary expansion (SARME) to the dentoalveolar, palatal and nasal structures by using tooth-borne distraction devices. Br J Oral Maxillofac Surg [Internet] 49(5):381–5. https://doi.org/10.1016/j.bjoms.2010.05.015

17.

Goldenberg DC, Goldenberg FC, Alonso N, Gebrin ES, Amaral TS, Scanavini MA et al (2008) Hyrax appliance opening and pattern of skeletal maxillary expansion after surgically assisted rapid palatal expansion: a computed tomography evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod [Internet] 106(6):812–9. https://doi.org/10.1016/j.tripleo.2008.02.034

18.

Zandi M, Miresmaeili, Amirfarhang, Heidari A (2014) Short-term skeletal and dental changes following bone-borne versus tooth-borne surgically assisted rapid maxillary expansion: a randomized clinical trial study. J Cranio-Maxillofacial Surg (7):1190–1195

19.

Oliveira TFM, Pereira-Filho VA, Gabrielli MAC, Gonçales ES, Santos-Pinto A (2016) Effects of lateral osteotomy on surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg [Internet] 45(4):490–6. https://doi.org/10.1016/j.ijom.2015.11.011

20.

Sygouros A, Motro M, Ugurlu F, Acar A (2014) Surgically assisted rapid maxillary expansion: cone-beam computed tomography evaluation of different surgical techniques and their effects on the maxillary dentoskeletal complex. Am J Orthod Dentofacial Orthop [Internet] 146(6):748–57. https://doi.org/10.1016/j.ajodo.2014.08.013

21.

Salgueiro DG, Rodrigues VH, Tieghi Neto V, Menezes CC, Gonçales ES, Ferreira Júnior O (2015 Jul-Aug) Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME) through cone beam computed tomography. J Appl Oral Sci 23(4):397–404. https://doi.org/10.1590/1678-775720140486PMID: 26398512; PMCID: PMC4560500

22.

Nada RM, Fudalej PS, Maal TJJ, Bergé SJ, Mostafa YA, Kuijpers-Jagtman AM (2012) Three-dimensional prospective evaluation of tooth-borne and bone-borne surgically assisted rapid maxillary expansion. J Craniomaxillofac Surg [Internet] 40(8):757–62. https://doi.org/10.1016/j.jcms.2012.01.026

23.

Xi T, Laskowska M, van de Voort N, Ghaeminia H, Pawlak W, Bergé S et al (2017) The effects of surgically assisted rapid maxillary expansion (SARME) on the dental show and chin projection. J Craniomaxillofac Surg [Internet] 45(11):1835–41. https://doi.org/10.1016/j.jcms.2017.08.023

24.

Gungor AY (2012) Comparison of the effects of rapid maxillary expansion and surgically assisted rapid maxillary expansion in the sagittal, vertical and transverse planes. Medicina oral, patologia oral y cirugia bucal

25.

Zandi M, Miresmaeili A, Heidari A, Lamei A (2016) The necessity of pterygomaxillary disjunction in surgically assisted rapid maxillary expansion: A short-term, double-blind, historical controlled clinical trial. J Craniomaxillofac Surg [Internet] 44(9):1181–6. https://doi.org/10.1016/j.jcms.2016.04.026

26.

Koç O, Jacob HB (2022) Surgically assisted rapid palatal expansion: is the pterygomaxillary disjunction necessary? A finite element study. Semin Orthod 28(3):227–242. https://doi.org/10.1053/j.sodo.2022.10.017CrossRef

27.

Suri L, Taneja P (2008) Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop 133(2):290–302. https://doi.org/10.1016/j.ajodo.2007.01.021. PMID: 18249297

28.

Romano FL, Sverzut CE, Trivellato AE, Saraiva MCP, Nguyen TT (2022) Alveolar defects before and after surgically assisted rapid palatal expansion (SARPE): a CBCT assessment. Dent Press J Orthod 27(2):e2219299. https://doi.org/10.1590/2177-6709.27.2.e2219299.oarPMID: 35703612; PMCID: PMC9191858CrossRef

29.

Cureton SL, Cuenin M (1999) Surgically assisted rapid palatal expansion: orthodontic preparation for clinical success. Am J Orthod Dentofacial Orthop 116(1):46–59. https://doi.org/10.1016/s0889-5406(99)70302-1. PMID: 10393580

30.

Atac A, Karasu AT, Hakan A, Aytac D (2006) Surgically assisted rapid maxillary expansion compared with orthopedic rapid maxillary expansion. Angle Orthod 353–359

31.

Romano F, Sverzut CE, Trivellato AE, Saraiva MCP, Nguyen TT (2022) Surgically assisted rapid palatal expansion (SARPE): three-dimensional superimposition on cranial base. Clin Oral Investig 26(5):3885–3897. https://doi.org/10.1007/s00784-021-04355-zEpub 2022 Jan 10. PMID: 35013784CrossRefPubMed

Title: Three-dimensional assessment of the maxilla after modified surgically assisted rapid expansion: a retrospective study
Authors: Felippe Almeida Costa
Marcelo Santos Bahia
Priscila Quintino Chabot
Cassio Edvard Sverzut
Alexandre Elias Trivellato
Publication date: 06-05-2024
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: Oral and Maxillofacial Surgery
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-024-01258-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Three-dimensional assessment of the maxilla after modified surgically assisted rapid expansion: a retrospective study

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content