Long-term 3D cast model study: bone-borne vs. tooth-borne surgically assisted rapid maxillary expansion due to secondary variables.
OBJECTIVE
This study aims to compare bone-borne (BB) surgically assisted rapid maxillary expansion (SARME) to tooth-borne (TB) SARME with regard to dentoskeletal effects.


METHODS
Measurements were performed on 3D scanned cast models of 34 patients preoperatively and 20.5 +/- 1.34 months post-expansion. Secondary variables were pterygomaxillary disjunction or not; bimaxillary osteotomy or not and patient age.


RESULTS
BB SARME without pterygomaxillary disjunction on patients <20 years led to a symmetric increase in transverse widening; however, simultaneously, to more dental tipping (canines/second molars) and to the biggest overall attachment loss (frontal teeth/premolars), especially, after the performance of bimaxillary osteotomy. TB SARME led to an asymmetric decrease in transverse widening and to more dental tipping (premolars/first molars).


CONCLUSIONS
In long-term effects, BB SARME led to a symmetric increase in transverse widening; however, at the price of frontal attachment loss, resulting from the initial asymmetric, but bigger, overall transverse widening, the initial major segmental rotation and the necessary orthodontics for tooth arch alignment before and after bimaxillary osteotomy.
Laudemann
Katharina
K
Oral-, Maxillofacial and Plastic Facial Surgery, Goethe University Frankfurt, Frankfurt, Germany. klaudemann@web.de
Petruchin
Oksana
O
Nafzger
Michael
M
Ballon
Alexander
A
Kopp
Stefan
S
Sader
Robert A
RA
Landes
Constantin A
CA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001641:Bicuspid / Q000473:pathology; D003481:Cuspid / Q000473:pathology; D003724:Dental Arch / Q000473:pathology / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007180:Incisor / Q000473:pathology; D008137:Longitudinal Studies; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D003765:Models, Dental; D008963:Molar / Q000473:pathology; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000295:instrumentation*; D010027:Osteotomy / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods; D010155:Palatal Expansion Technique / Q000009:adverse effects / Q000295:instrumentation*; D017622:Periodontal Attachment Loss / Q000209:etiology; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery; D019228:Tooth Crown / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult