Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto (FORP/USP), University of São, Paulo - Cafe Ave, S/N, West Sub-sector, Ribeirão Preto, São Paulo, 14040-904, Brazil.
Oral Maxillofac Surg. 2024 Sep;28(3):1295-1302. doi: 10.1007/s10006-024-01258-7. Epub 2024 May 6.
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.
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.
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.
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.
本回顾性研究旨在评估 28 例接受改良经翼突辅助上颌快速扩张术（SARME）而未行翼突板剥离术的患者的三维牙颌骨效应和正中腭缝张开模式。
通过锥形束 CT（CBCT）对 2009 年至 2016 年间接受改良 SARME 的 28 例患者进行回顾性评估。在三个不同的手术期（扩张前-T0；Hyrax 装置激活结束时-T1；以及装置固定 6 个月后-T2）进行牙颌骨测量。使用 SPSS 软件进行统计学分析，包括方差分析和 Pearson 相关系数。
SARME 显示出明显的上颌横向扩张（平均 6.05mm），前区影响更大。牙测量，包括犬齿和磨牙距离，在手术期间有显著变化。骨骼测量（ANS 和 PNS）显示出较小但有统计学意义的改变，包括在装置激活期间 ANS 轻微向下位移。鼻底宽度增加，固定后宽度减少。正中腭缝主要表现为 II 型（V 型）张开。
改良 SARME 呈现出横向增加和超低位骨移位，前区比后区受影响更大。上颌的前后方向没有变化。此外，牙线性测量增加，角测量减少，治疗期间后骨扩张量与磨牙扩张量呈正相关。
