title: Surgical management of cross-bites in orthognathic surgery: Surgically assisted rapid maxillary expansion (SARME) versus two-piece maxilla.
abstract: OBJECTIVE
  The surgical treatment of cross-bites includes surgically-assisted maxillary expansion (SARME) or maxillary-bipartition during bimaxillary surgery. This study evaluates and compares the changes in the teeth and lower nasal passage, as well as the stability of the expansion.
  
  
  METHODS
  The measurements were performed on the cone-beam computed tomography (CBCT) scans of 32 patients with transverse (width) deficiencies of the maxilla. To expand the maxilla, 12 patients underwent the two-piece maxilla method, while 20 patients received SARME.
  
  
  RESULTS
  The mean distraction width for SARME was 6.8 mm (SD 3.7), while that for the two-piece maxilla was 4.1 mm (SD 1.6). The expansion with SARME was over the entire length of the maxilla, from anterior to posterior, whereas the expansion of the two-piece patient group was only in the posterior part of the maxilla. The segments of the maxilla opened nearly parallel in SARME, while they were reverse V-shaped in the two-piece maxilla, from anterior to posterior.
  
  
  CONCLUSIONS
  A key point in the planning of combined orthodontic-orthognathic therapy with surgical correction of a cross-bite is the precise determination of the area where the width needs to be increased, and the amount of correction needed to treat the patient using minimal surgical procedures.
authors.affiliation: Department of Oral and Maxillofacial Surgery (Prof. Dr. Dr. J. Hoffmann, PhD, MD, DDS), University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Department of Oral and Maxillofacial Surgery, Teaching Hospital of Frankfurt University Medical Center, Hessenring 128, 61348 Bad Homburg, Germany. Electronic address: rseeberger@t-online.de.
authors.forename: Robin
authors.initials: R
authors.lastname: Seeberger
authors.affiliation: Department of Oral and Maxillofacial Surgery (Prof. Dr. Dr. J. Hoffmann, PhD, MD, DDS), University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Gander
authors.affiliation: Department of Oral and Maxillofacial Surgery (Prof. Dr. Dr. J. Hoffmann, PhD, MD, DDS), University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoffmann
authors.affiliation: Department of Oral and Maxillofacial Surgery (Prof. Dr. Dr. J. Hoffmann, PhD, MD, DDS), University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Engel
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D008310:Malocclusion / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D057909:Orthognathic Surgery / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D012189:Retrospective Studies
keywords: Distraction-osteogenesis; Maxillary-bipartition; Orthognathic surgery; Surgically assisted maxillary expansion; Two-piece maxilla