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Published on: October 20, 2023
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Nasolabial changes after two different approaches for surgically assisted rapid maxillary expansion
N Alves1, T F M Oliveira2, V A Pereira-Filho3
1Surgical Sciences, School of Medical Sciences, State University of Campinas, UNICAMP, Campinas, SP, Brazil.
Summary
Surgically assisted rapid maxillary expansion (SARME) can alter nasolabial aesthetics. Different surgical techniques impact alar base width changes, but neither approach fully prevents width increase.
Area of Science:
- Orthodontics
- Maxillofacial Surgery
- Plastic Surgery
Background:
- Surgically assisted rapid maxillary expansion (SARME) is a common procedure for correcting maxillary hypoplasia.
- The impact of different surgical approaches on nasolabial changes following SARME requires further investigation.
Purpose of the Study:
- To compare the nasolabial changes resulting from two distinct surgical approaches for SARME.
- To evaluate the influence of surgical technique on alar base width, nasal length, projection, and upper lip length.
Main Methods:
- Retrospective study of 19 patients undergoing SARME.
- Two surgical groups: standard Le Fort I approach with alar cinch vs. subtotal vestibular approach without alar cinch.
- Cone beam computed tomography (CBCT) scans analyzed preoperatively (T1) and 6 months postoperatively (T2).
Main Results:
- Both SARME approaches led to a significant increase in alar base width.
- The subtotal vestibular approach (group 2) resulted in smaller alar base width increases at the superior alar curvature compared to the standard approach (group 1).
- Nasal length, nasal projection, and upper lip length remained unchanged in both groups post-SARME.
Conclusions:
- The surgical approach influences nasolabial changes after SARME, particularly alar base width.
- While the subtotal vestibular approach may offer a slight advantage in minimizing alar base widening, neither technique completely eliminates this effect.

