The effects of surgically assisted rapid maxillary expansion (SARME) on the dental show and chin projection

Abstract

ObjectiveTo quantify the postoperative changes of the dental show and chin projection following SARME using 3D CBCT imaging. Material and methods78 patients with transversal maxillary hypoplasia and mandibular hypoplasia who underwent SARME were enrolled into the study. A cone beam computed tomography (CBCT) scan was acquired preoperatively and at least 1 year postoperatively. 3D postoperative changes in the dental show and pogonion position were measured based on soft tissue and hard tissue landmarks. Results68 patients (87%) exhibited a postoperative increase in the dental show. The dental show was increased by a mean of 2.2 ± 2.0 mm (p < 0.01). The mean horizontal and vertical displacement of the chin (pogonion) following SARME was 1.6 ± 2.5 mm posteriorly and 1.6 ± 2.0 mm inferiorly (p < 0.01). An inferior displacement of the maxilla and maxillary tooth as well as a consequent clockwise pitch of the mandible seemed to play a role in inducing these postoperative changes. ConclusionAn increase in dental show and a posterior and inferior displacement of the chin should be considered prior to SARME to prevent undesirable postoperative changes of the facial esthetics.