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Surgically assisted rapid palatal expansion (SARPE): three-dimensional superimposition on cranial base
Fábio Romano1,2, Cássio Edvard Sverzut3, Alexandre Elias Trivellato3
1Department of Pediatric Dentistry, Orthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. fabioromano@forp.usp.br.
Surgically assisted rapid palatal expansion (SARPE) in adults causes significant buccal tooth tipping and anterior maxillary movement. Bone expansion is less than tooth movement, with stable nasal width post-treatment.
Area of Science:
- Orthodontics and Dentofacial Orthopedics
- 3D Imaging in Dentistry
- Craniofacial Surgery
Background:
- Surgically assisted rapid palatal expansion (SARPE) is used to correct transverse maxillary deficiencies.
- Understanding the precise dental and skeletal changes following SARPE is crucial for treatment planning.
Purpose of the Study:
- To evaluate dental and skeletal changes after SARPE using 3D CBCT image superimposition on the cranial base.
- To quantify tooth movement, bone expansion, and maxillary repositioning.
Main Methods:
- Retrospective before-and-after study of 24 adult patients.
- Three-dimensional cone-beam computed tomography (CBCT) scans were taken before, immediately after, and 6 months post-SARPE.
- CBCT images were superimposed on the anterior cranial base using voxel-based registration.
Main Results:
- Significant buccal tipping of posterior teeth occurred, with some residual root movement observed.
- Bone expansion achieved was 65-70% of the tooth movement.
- The maxilla and anterior teeth moved anteriorly, and nasal width increased significantly and remained stable.
Conclusions:
- SARPE in adults leads to significant buccal tooth tipping and anterior maxillary advancement.
- The skeletal expansion is less than the dental expansion, with no significant expansion at the zygomatic arch.
- Findings provide valuable data for clinicians planning SARPE treatments.
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