One-stage tooth-borne distraction versus two stage bone-borne distraction in surgically assisted maxillary expansion (SARME)

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Dec;120(6):693-8. doi: 10.1016/j.oooo.2015.07.009. Epub 2015 Jul 22.


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.

Study design: 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.

MeSH terms

  • Adult
  • Cone-Beam Computed Tomography
  • Female
  • Humans
  • Male
  • Maxilla / abnormalities
  • Maxilla / diagnostic imaging
  • Maxilla / surgery*
  • Maxillary Osteotomy
  • Orthodontic Appliance Design
  • Orthodontics, Corrective
  • Orthognathic Surgical Procedures
  • Osteogenesis, Distraction / instrumentation*
  • Osteotomy, Le Fort
  • Palatal Expansion Technique / instrumentation*
  • Retrospective Studies
  • Treatment Outcome