4.3 Article

Three-dimensional dentoskeletal changes following minimally invasive surgically assisted rapid palatal expansion: a prospective study

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CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2022.07.004

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Minimally invasive surgical proce-dures; Palatal expansion technique; Maxillary osteotomy; Dentofacial deformities; Maxillofacial abnormalities

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This study used cone beam computed tomography (CBCT) to evaluate dentoskeletal changes in minimally invasive surgically assisted rapid palatal expansion (SARPE). The results showed a statistically significant increase in the linear transverse dimensions of the maxilla, as well as dental inclination to the buccal aspect. However, significant expansion of the maxilla at the skeletal and dentoalveolar levels was confirmed.
Dentoskeletal changes in minimally invasive surgically assisted rapid palatal expansion (SARPE) were evaluated using cone beam computed tomography (CBCT). This was a prospective study of 30 patients who underwent minimally invasive SARPE performed under local anaesthesia plus sedation by the same surgeon, in an ambulatory setting. Pre-and postoperative CBCT images were obtained for each patient. A statistically significant increase in the linear transverse dimensions of the maxilla occurred systematically. In the canine region, a mean increase of 5.84 mm occurred at the apex level and 7.82 mm at the crown level. These dimensions were 4.83 mm and 7.68 mm, respectively, in the molar region. The cross-sectional area of the maxilla increased by a mean 12.9 mm2 at the palate level and 23.3 mm2 at the crown level. Dental inclination to the buccal aspect was detected (mean 6.1 degrees at the canines and 8.4 degrees at the first molars). The alveolar process tipped buccally 10 degrees at the molar level. Nasal width increased a mean of 3.0 mm at the canine level. Through a three-dimensional analysis, this study found that minimally invasive SARPE was effective in the correction of transverse maxillary discrepancies > 5 mm in non-growing patients. Although dental inclination to the buccal aspect occurred, significant expansion of the maxilla at the skeletal and dentoalveolar levels was confirmed.

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