Abstract
Transverse discrepancy is an important factor in determining facial esthetics. It
has been shown there is an inverse correlation between the buccal corridor width and
the intercanine and intermolar widths. Despite the fact midpalatal expansion is the
treatment of choice for growing subjects, for skeletally mature subjects the rapid
palatal expansion has limited orthopedic effects, and surgically assisted rapid palatal
expansion (SARPE) is preferred. SARPE has shown inconsistencies depending on the surgical
technique and/or expander device design. Some authors suggest that median and lateral
osteotomies are sufficient to achieve the desired transverse dimensions using the
SARPE procedure, while others recommend additional surgical separation of the pterygomaxillary
junction. There are still controversies regarding the pterygomaxillary sutures (PMS)
disjunction effect. Therefore, this study aimed to evaluate the displacement and stress
distribution of the craniofacial structures resulting from SARPE, either with or without
PMS osteotomy, using two different expander design (tooth-borne and tooth-bone-borne)
using finite element method and finite element analysis (FEM/FEA). Regardless of the
maxillary expander device type, both SARPE surgical techniques effectively produced
maxillary expansion. SARPE with PMS osteotomy presented parallel maxillary expansion,
and reduced stress values in the craniofacial and maxillofacial structures.
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Published online: November 03, 2022
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