Abstract
ObjectivesSurgically assisted rapid maxillary expansion (SARME) is a treatment modality to overcome maxillary constrictions. During the procedure of transverse expansion, unwanted asymmetries can occur. This retrospective study investigates the transverse expansion behavior of the maxilla utilizing a simulation-driven SARME with targeted bone weakening.Materials and methodsCone beam computer tomographies of 21 patients before (T1) and 4 months after treatment (T2) with simulation-driven SARME combined with a transpalatal distractor (TPD) and targeted bone weakening were superimposed. The movements of the left, right, and frontal segments were evaluated at the modified WALA ridge, mid root level, and at the root tip of all upper teeth. Linear and angular measurements were performed to detect dentoalveolar changes.ResultsDentoalveolar changes were unavoidable, and buccal tipping of the premolars (6.1° ± 5.0°) was significant (p < 0.05). Transverse expansion in premolar region was higher (6.13 ± 4.63mm) than that in the molar region (4.20 ± 4.64mm). Expansion of left and right segments did not differ significantly (p > 0.05).ConclusionSimulation-driven SARME with targeted bone weakening is effective to achieve symmetrical expansion in the transverse plane.Clinical relevanceSimulation-driven targeted bone weakening is a novel method for SARME to achieve symmetric expansion. Dental side effects cannot be prohibited.
Highlights
Maxillary constriction is a malocclusion with a prevalence of 8 to 10%, which can be observed in adolescents and adults [1, 2]
Studies have shown that the posterior crossbite is one of the most common dental malocclusions with a prevalence of 8 to 22% [5]
Data of all patients of the Department of Cranial and Maxillofacial Surgery, in Dortmund, who underwent a Surgically assisted rapid maxillary expansion (SARME) in the period from May 2006 to June 2017 as part of an interdisciplinary orthodontic-surgical treatment, were examined for symmetry regarding the expansion procedure
Summary
Maxillary constriction is a malocclusion with a prevalence of 8 to 10%, which can be observed in adolescents and adults [1, 2]. Studies have shown that the posterior crossbite is one of the most common dental malocclusions with a prevalence of 8 to 22% [5]. The main goal of treatment of skeletal crossbites caused by maxillary constrictions is to achieve a transverse skeletal expansion of the maxilla with the least possible dental influence, in order to achieve harmony of the lower and upper dental arches and to eliminate the discrepancies. University of Witten/Herdecke, Klinikum Nord, Münsterstr. 240, 44145 Dortmund, Germany 4 Private orthodontic clinic, Am Bahnhof 54, 56841 Traben-Trarbach, Germany cavities, arch length discrepancies, and anterior crowding but is usually associated with a posterior crossbite occurring unilaterally or bilaterally [3, 4].
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