Surgical Assisted Rapid Palatal Expansion: Evaluation between Two Different Rapid Maxillary Expansion Surgical Techniques. Bone expansion and Post Operative Patient Discomfort Evaluation

Resi Pucci ¹ Paolo Priore ² Giulia Di Benedetto ¹ Filippo Giovannetti ² Andrea Cassoni ² Valentino Valentini ¹

¹Dipartimento di Scienze Odontostomatologiche e Chirurgia Maxillo-Facciale, Scuola di Specializzazione in Chirurgia Maxillo-facciale - "Sapienza" Università di Roma
²Dipartimento di Scienze Odontostomatologiche e Chirurgia Maxillo-Facciale, U.O.D. Chirurgia Oncologica Ricostruttiva Maxillo-Facciale - Policlinico Umberto I di Roma

Objectives: Transverse Maxillary Discrepancy (TMD) is one of the most common dent skeletal deformities. Maxillary hypoplasia is characterized by the failure of the maxillary growth in the transverse, sagittal and vertical directions, it can lead to skeletal class II or III malocclusions. Adult patients with more than 5 mm of TMD are fit for surgically assisted rapid palatal expansion (SARPE). The aim of the present study was to compare the effects of Conventional SARPE technique and Minimally Invasive Endoscopic SARPE technique in adult patients.

Methods: This is a prospective cohort study twelve patients were included, randomly divided in two groups and treated with different surgical technique. CBCT scans were taken preoperatively and 1 month postoperative. Four landmark measurements of dental-to-skeletal change were used to follow skeletal and dental widths in the posterior and anterior maxillary regions. VAS pain scale and post-operative patient discomfort questionnaire were submitted to all patients. Long of Stay and post-operative analgesia were recorded.

Results: Patients showed an increase in posterior and anterior skeletal width from T0 to T1. Group 1 had a mean posterior expansion of 5.4 +/- 1.3 and a mean expansion of 4.4 +/- 2.5 in the anterior maxilla. Group 2 showed a mean posterior expansion of 6.8 +/- 1.9 and a mean anterior expansion of 6.7 +/- 1.1, these values were not statistically meaningful for the small sample. Mean value VAS pain scale was 4 in group 1 and 2.5 in group 2 and post-operative patient discomfort questionnaire showed minor swelling and lower use of analgesic in group 2.

Conclusion: The study demonstrates that the Minimally Invasive Endoscopic SARPE technique could be an interesting alternative to conventional SARPE. This technique reduces the post-operative patient discomfort with the same results in term of bone expansion, operative time and long of stay.