Objective: a surgically assisted rapid maxillary and mandibular expansion (SARMME) is an alternative approach to the traditional treatment of transverse maxillary and mandibular deficiencies and crowding. Besides, SARMME followed by maxillomandibular advancement (MMA) might be an even more effective form of treatment for patients with severe obstructive sleep apnea (OSA) than MMA alone. However, to date the role of the transverse dimension in OSA is not yet fully understood. The aim of this study is to report the effects of SARMME on both the airway and soft tissues morphology. Methods: In this prospective study, skeletally mature, non-syndromic patients with transverse maxillary and mandibular hypoplasia, who underwent a bimaxillary transverse osteodistraction between 2010 and 2012, were included. Surgical changes were analyzed using CT scans and 3D facial surface data before (T0) and after (T1) surgery. Results: Sixteen patients (4 male and 12 female; average age: 26.3 years) were enrolled.SARMME produces facial changes in the cheek, paranasal areas, nasal base and chin. These changes are more evident at 6 months and seem stable at 1 year. Facial changes are mostly explained by the underlying skeletal movements, which are essentially represented by the transverse enlargement of both the maxilla and the mandible.Following SARMME, the total airway volume and the lateral dimension of the cross-sectional airway increased significantly. Conclusions: SARMME is a new technique that allows an increase in both maxillary and mandibular arch perimeters simultaneously by increasing skeletal width. Facial appearance is improved because of the reduction of the buccal corridors and the fullness of the mouth.While SARMME has a definite role in the armamentarium of correction of orthognatic deformities more experience and further long-term follow-up studies are needed to evaluate the efficacy in OSAS patients.
Airway morphology and facial soft-tissues changes after maxillo-mandibular transverse distraction: 3D CT analysis and 3D surface laser scanner evaluations
GERBINO, GIOVANNI;ZAVATTERO, EMANUELE;VERZE', Laura;CORSICO, Marco;BAIETTO, Federico;RAMIERI, Guglielmo
2014-01-01
Abstract
Objective: a surgically assisted rapid maxillary and mandibular expansion (SARMME) is an alternative approach to the traditional treatment of transverse maxillary and mandibular deficiencies and crowding. Besides, SARMME followed by maxillomandibular advancement (MMA) might be an even more effective form of treatment for patients with severe obstructive sleep apnea (OSA) than MMA alone. However, to date the role of the transverse dimension in OSA is not yet fully understood. The aim of this study is to report the effects of SARMME on both the airway and soft tissues morphology. Methods: In this prospective study, skeletally mature, non-syndromic patients with transverse maxillary and mandibular hypoplasia, who underwent a bimaxillary transverse osteodistraction between 2010 and 2012, were included. Surgical changes were analyzed using CT scans and 3D facial surface data before (T0) and after (T1) surgery. Results: Sixteen patients (4 male and 12 female; average age: 26.3 years) were enrolled.SARMME produces facial changes in the cheek, paranasal areas, nasal base and chin. These changes are more evident at 6 months and seem stable at 1 year. Facial changes are mostly explained by the underlying skeletal movements, which are essentially represented by the transverse enlargement of both the maxilla and the mandible.Following SARMME, the total airway volume and the lateral dimension of the cross-sectional airway increased significantly. Conclusions: SARMME is a new technique that allows an increase in both maxillary and mandibular arch perimeters simultaneously by increasing skeletal width. Facial appearance is improved because of the reduction of the buccal corridors and the fullness of the mouth.While SARMME has a definite role in the armamentarium of correction of orthognatic deformities more experience and further long-term follow-up studies are needed to evaluate the efficacy in OSAS patients.
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