Surgically assisted maxillary expansion with or without pterygoid disjunction alters maxillomandibular positioning

Oral Maxillofac Surg. 2023 Jun;27(2):269-281. doi: 10.1007/s10006-022-01062-1. Epub 2022 Apr 15.

Abstract

Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and 3D Slicer software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis (3D Slicer software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.

Keywords: Cone-beam computed tomography; Mandible; Pterygomaxillary disjunction; Surgically assisted maxillary expansion.

MeSH terms

  • Cephalometry / methods
  • Cone-Beam Computed Tomography / methods
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Maxilla* / diagnostic imaging
  • Maxilla* / surgery
  • Palatal Expansion Technique*