Surgically assisted rapid palatal expansion (SARPE): three-dimensional superimposition on cranial base

Abstract

Objectives: To evaluate dental and skeletal changes caused by surgically assisted rapid palatal expansion (SARPE) using the superimposition of three-dimensional cone-beam computed tomography (CBCT) images on the cranial base.

Material and methods: This is a retrospective quasi-experiment before-and-after study using a convenience sample. Twenty-four adult patients (13 male and 11 female) were evaluated before SARPE (T0), immediately after expansion (T1), and after 6 months of retention (T2). CBCT scans were superimposed on the anterior cranial base using voxel-based registration. Measurements from different reference points were used for comparisons between times.

Results: At T1, all teeth had significant buccal tipping. At T2, most teeth remained in the same position as at T1, except the first premolar and the first molar, whose buccal roots moved slightly. The amount of bony expansion was 65 to 70% of the amount of tooth movement. The A point and maxillary incisors moved anteriorly from T0 to T1 and T2 (p < 0.0001). Inter-nasal distance had increased significantly at T1 (p < 0.0001) and remained stable at T2 (p = 0.478). No expansion was achieved at the zygomatic arch (p = 0.114).

Conclusion: SARPE promoted substantial buccal tipping of posterior teeth and some bone displacement; it also moved the maxilla and teeth forward and increased nasal width.

Clinical relevance: No other clinical studies have evaluated dental and skeletal changes caused by SARPE using superimposition of 3D CBCT images on the cranial base. This study findings may help clinical dentists plan treatments using safe and reliable information.

Keywords: Cone beam computed tomography; Oral surgical procedures; Orthodontics; Orthognathic surgical procedures; Palatal expansion; Surgically assisted rapid palatal expansion.