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One-stage tooth-borne distraction versus two stage bone-borne distraction in surgically assisted maxillary expansion
Robin Seeberger1, Dorothee Abe-Nickler2, Jürgen Hoffmann3
1Oral-Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of Oral and Maxillofacial Surgery, Teaching Hospital of Frankfurt University Medical Center, Bad Homburg, Germany.
Objective:
To evaluate and compare the effects of tooth-borne and bone-borne distraction devices in surgically assisted maxillary expansion (SARME) on dental and skeletal structures.
Study Design:
A sample of 33 skeletally mature patients with transverse maxillary deficiencies was examined with cone beam computed tomography (CBCT) before and 3 months after surgery. Fourteen patients were treated with tooth-borne devices and 19 patients with bone-borne devices.
Results:
Dental crown expansion in the first premolars did not differ significantly between the two groups, and median expansion was 5.55 mm (interquartile range [IQR] 5.23) in the tooth-borne device group and 4.6 mm (IQR 3.4) in the bone-borne device group. In the first molars, crown expansion and lateral tipping were significantly greater in the tooth-borne device group (P ≤ .02). The median skeletal nasal isthmus increase was significantly more in the bone-borne device group at 3.0 mm than in the tooth-borne device group at 0.98 mm (P ≤ .02).
Conclusions:
Both tooth-borne and bone-borne devices are effective treatment modalities to correct maxillary transverse deficiencies. Bone-borne devices produced greater widening of the skeletal nasal floor and fewer dental side effects in the first molars.
