Nasal soft- and hard-tissue changes following tooth-borne and hybrid surgically assisted rapid maxillary expansion: a randomized clinical cone-beam computed tomography study

Publication date: Available online 10 January 2019

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Emre Kayalar, Michael Schauseil, Andreas Hellak, Ufuk Emekli, Sönmez Fıratlı, Heike Korbmacher-Steiner

Summary

Purpose

The aim of this study was to assess the effects of tooth/bone-borne (hybrid) and tooth-borne (TB) surgically assisted rapid maxillary expansion (SARME) on the width of the nasal soft and hard tissue.

Patients and methods

Twenty skeletally mature patients (nine males and 11 females; mean age 19.4 years) with transverse maxillary hypoplasia were randomly assigned to hybrid or TB devices. The patients had undergone SARME operations, performed by the same surgical team using the same procedure (Le Fort I osteotomy with pterygomaxillary dysjunction, midline osteotomy, and no down-fracture). Nasal soft- and hard-tissue changes were analyzed using CBCT preoperatively (T0), at the end of the active expansion phase (T1), and after 6 months of retention (T2). The study was approved by the relevant ethics committee.

Results

The skeletal and soft-tissue nasal parameters increased significantly in the T0–T1 and T0–T2 periods in both groups (P < 0.05). No statistically significant differences between the groups were observed. The mean piriform aperture width increased from 1.26 mm in T0–T1 to 0.97 mm in T1–T2 and 2.17 mm in T0–T2 (P < 0.008). In the soft tissue, the alar base width increased to 2.78 mm and the alar width to 2.95 mm in T0–T2 (P = 0.001). There was a positive correlation (63.6%) between the changes in skeletal and soft-tissue values.

Conclusion

The hybrid and TB devices led to similarly significant widening effects in nasal soft and hard tissues in both the short term and 6 months after SARME.

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