Effects of pterygomaxillary separation on skeletal and dental changes following surgically assisted rapid maxillary expansion: A single-center, double-blind, randomized clinical trial

Publication date: Available online 31 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Marcelo Ferraro-Bezerra, Rodrygo Nunes Tavares, José Rômulo de Medeiros, Alexandre Simões Nogueira, Rafael Linard Avelar, Eduardo Costa Studart Soares
PurposeSurgically assisted rapid maxillary expansion is a procedure that is routinely performed for the correction of transverse maxillary deformities, and it can be performed with or without pterygomaxillary disjunction. The aim of this study is to measure the effect of the amount of expansion and stability of surgically assisted rapid maxillary expansion (SARME) with or without pterygomaxillary dysjunction (PD).Materials and MethodsThe investigators designed and implemented a double-blind, randomized clinical trial. Patients were randomly assigned to two different groups: (G1) SARME - PD and (G2) SARME + PD. Cone-beam computed tomography scans were performed at 3 timepoints: baseline (T0), after maxillary expansion (T1), and at the end of the retention period (T2). Dental and bone expansion and dental inclination at maxillary canine and first molars region were assessed. Two-way Repeated Measures (RANOVA) was used to evaluate differences between the two groups at the three evaluation periods (T0, T1 and T2), using a level of significance of p <0.05.ResultsTwenty-four patients underwent maxillary surgical expansion (G1 n=12 and G2 n=12). Both techniques promoted a significant transverse dental expansion in the first molar at T2 (+PD: 5.4 mm versus −PD: 6.4 mm; −6.18 mm to 1.48 mm), but no statistically significant differences were observed between groups. The tipping molars at T2 remained at a higher level in the SARME–PD group compared to the SARME+PD group (+PD: 2.3° versus –PD: 4.6° for 3 teeth,–12.72° to 5.57°; and +PD: 1.6° versus –PD: 3.6° for 14 teeth: –9.96° to 9.83°).ConclusionSARME with PD and SARME without PD are reliable methods for obtaining maxillary expansion, with slight differences in the patterns of skeletal and dental alterations.



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