Effects of pterygomaxillary separation on skeletal and dental changes following surgically-assisted rapid maxillary expansion

Han, In Ho; An, Jin Suk; Gu, Hong; Kook, Min Suk; Park, Hong Ju; Oh, Hee Kyun

Abstract

PURPOSE: The aim of this study was to evaluate the effects of pterygomaxillary separation on dimensional changes of dental arch following surgically-assisted rapid maxillary expansion (SARME).
PATIENTS AND METHODS
Eighteen adults who had been treated by SARME for transverse maxillary deficiency from May 2000 to August 2005 were evaluated. Thirteen patients (Group 1) were treated with subtotal Le Fort I osteotomy including pterygomaxillary separation and anterior midpalatal osteotomy. The same operation was performed in five patients (Group 2) except pterygomaxillary separation. Dental study casts were taken before operation and after removal of expansion device. And then, skeletal and dental parameters were measured pre- and post-operatively.
RESULTS
1. Changes of mean interdental width 1) In group 1, mean maxillary interdental width was increased 70%(47~99%), 95%(84~115%), and 77%(57~94%) of total expansion on canine, first premolar, and first molar region, respectively after retention. 2) In group 2, mean maxillary interdental width was increased 77%(59~100%), 78%(45~107%), and 86%(57~116%) of total expansion on canine, first premolar, and first molar region, respectively after retention. 3) There was a statistical difference between the change of interdental width of group 1 and group 2 at first premolar(p<0.05). 2. Changes of mean interalveolar width 1) In group 1, mean maxillary alveolar bone width was increased 66%(42~84%), 74%(42~104%), and 57%(31~78%) of total expansion on canine, first premolar, and first molar region, respectively after retention. 2) In Group 2, mean maxillary alveolar bone width was increased 73%(55~98%), 67%(36~89%), and 59%(48~73%) of total expansion on canine, first premolar, and first molar region, respectively after retention. 3) There were no statistical differences between group 1 and group 2 at each teeth area.
CONCLUSION
These results suggest that SARME without pterygomaxillary separation may allow the relatively equal expansion at both anterior and posterior teeth area and most amounts of maxillary interdental expansions were acquired with the expansion of the maxilla by SARME.