One-stage tooth-borne distraction versus two stage bone-borne distraction in surgically assisted maxillary expansion (SARME).
OBJECTIVE
To evaluate and compare the effects of tooth-borne and bone-borne distraction devices in surgically assisted maxillary expansion (SARME) on dental and skeletal structures.


METHODS
A sample of 33 skeletally mature patients with transverse maxillary deficiencies was examined with cone beam computed tomography (CBCT) before and 3 months after surgery. Fourteen patients were treated with tooth-borne devices and 19 patients with bone-borne devices.


RESULTS
Dental crown expansion in the first premolars did not differ significantly between the two groups, and median expansion was 5.55 mm (interquartile range [IQR] 5.23) in the tooth-borne device group and 4.6 mm (IQR 3.4) in the bone-borne device group. In the first molars, crown expansion and lateral tipping were significantly greater in the tooth-borne device group (P ≤ .02). The median skeletal nasal isthmus increase was significantly more in the bone-borne device group at 3.0 mm than in the tooth-borne device group at 0.98 mm (P ≤ .02).


CONCLUSIONS
Both tooth-borne and bone-borne devices are effective treatment modalities to correct maxillary transverse deficiencies. Bone-borne devices produced greater widening of the skeletal nasal floor and fewer dental side effects in the first molars.
Oral-Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of Oral and Maxillofacial Surgery, Teaching Hospital of Frankfurt University Medical Center, Bad Homburg, Germany.
Robin
R
Seeberger
Resident, Department of Oral and Maxillofacial Surgery, University Hospital Lübeck, Lübeck, Germany.
Dorothee
D
Abe-Nickler
Professor and Chairman, Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Jürgen
J
Hoffmann
Statistician, Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Kevin
K
Kunzmann
Orthodontist, Department of Orthodontics, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: Sebastian.Zingler@med.uni-heidelberg.de.
Sebastian
S
Zingler
D000328:Adult; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D063166:Maxillary Osteotomy; D016382:Orthodontic Appliance Design; D009971:Orthodontics, Corrective; D056948:Orthognathic Surgical Procedures; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D019340:Osteotomy, Le Fort; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D012189:Retrospective Studies; D016896:Treatment Outcome