title: Surgically assisted rapid maxillary expansion: cone-beam computed tomography evaluation of different surgical techniques and their effects on the maxillary dentoskeletal complex.
abstract: BACKGROUND
  The aims of this study were to evaluate and compare skeletal, dentoalveolar, dental, and periodontal changes in surgically assisted rapid maxillary expansion (SARME) patients with and without pterygomaxillary disjunction.
  
  
  METHODS
  The records of 20 patients who underwent SARME in the clinics of the dental school at Marmara University in Turkey were collected and divided into 2 groups of 10 patients each, according to the surgical protocol followed. Cone-beam computed tomography images before the operation and 3 to 6 months after the end of active expansion were analyzed by 20 linear and 7 angular measurements. The reliability of the 3-dimensional analysis was investigated.
  
  
  RESULTS
  All transversal measurements in the dentoalveolar and dental levels increased after expansion in both the SARME with pterygomaxillary disjunction and the SARME without pterygomaxillary disjunction groups with no significant differences between them. In the SARME without pterygomaxillary disjunction group, more pronounced buccal alveolar bending and buccal tipping of the posterior teeth were found, but the difference did not reach statistical significance. SARME reduces buccal alveolar width in the premolar region significantly when pterygoid disjunction is not performed.
  
  
  CONCLUSIONS
  SARME with or without pterygomaxillary disjunction is an effective technique to treat maxillary transverse deficiency in adolescent and adult patients. Pterygomaxillary disjunction is advised in periodontally compromised patients. Cone-beam computed tomography scanning is a reliable method for studying the dentoskeletal effects of SARME.
authors.affiliation: Private practice, Zakynthos, Greece. Electronic address: antonysig@gmail.com.
authors.forename: Antonios
authors.initials: A
authors.lastname: Sygouros
authors.affiliation: Research assistant, Department of Orthodontics, Marmara University, Istanbul, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Motro
authors.affiliation: Associate professor, Department of Oral and Maxillofacial Surgery, Marmara University, Istanbul, Turkey.
authors.forename: Faysal
authors.initials: F
authors.lastname: Ugurlu
authors.affiliation: Professor, Department of Orthodontics, Marmara University, Istanbul, Turkey.
authors.forename: Ahu
authors.initials: A
authors.lastname: Acar
mesh_terms: D000293:Adolescent; D000539:Alveolar Process / Q000000981:diagnostic imaging; D001641:Bicuspid / Q000000981:diagnostic imaging; D002508:Cephalometry / Q000379:methods; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003481:Cuspid / Q000000981:diagnostic imaging; D003724:Dental Arch / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging*; D063166:Maxillary Osteotomy / Q000379:methods; D008963:Molar / Q000000981:diagnostic imaging; D016382:Orthodontic Appliance Design; D019340:Osteotomy, Le Fort / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation; D056739:Pterygopalatine Fossa / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D055815:Young Adult; D015050:Zygoma / Q000000981:diagnostic imaging