A Comparison of Tooth-Borne and Bone-Anchored Expansion Devices in SARME

Oral Maxillofac Surg. 2020 Jun;24(2):181-187. doi: 10.1007/s10006-020-00837-8. Epub 2020 Apr 14.


Purpose: Major adult maxillary transverse discrepancies are usually treated with surgically assisted rapid maxillary expansion (SARME), utilizing a combination of surgical and orthodontic techniques. Unfortunately, a consensus has not been reached on topics ranging from the best surgical technique that should be performed to the ideal expander type that should be installed. The present study sought to evaluate the efficiency and stability of the maxillary expansion achieved with two types of expanders following the same SARME procedure without pterygomaxillary disjunction (PMD).

Methods: Twenty-four patients with a maxillary transverse deficiency were enrolled in the study. All patients underwent the same SARME, and 12 received a bone-anchored (KLS Martin®) and 12 were installed with a tooth-borne (Hyrax®) expander. Dental impressions were collected both preoperatively and 1 year postoperatively. These casts were scanned and the distances between specific interdental and intergingival points were measured and analyzed. Statistical analyses were performed to assess the effects expander type had on the efficiency of the maxillary expansion and long-term stability.

Results: Expansion in the anterior maxillary and premolar regions was found to be similar in both groups. In contrast, the tooth-borne device resulted in a significantly greater expansion in the molar region.

Conclusion: The SARME technique without PMD is highly effective at treating adults with maxillary transverse deficiencies, and the type of expander selected depends on the location of the larger maxillary constriction region of each patient.

Keywords: Dental impressions; Maxillary expansion; Orthognathic surgery; Osteogenesis distraction; Pterygomaxillary disjunction.

MeSH terms

  • Adult
  • Bicuspid
  • Humans
  • Maxilla*
  • Molar
  • Palatal Expansion Technique*