Three-segment versus 2-segment surgically assisted rapid maxillary expansion.

ABSTRACT Objective: To compare the two surgically assisted rapid maxillary expansion (SARME) techniques, the conventional 2-segment osteotomy between maxillary central incisors, and the 3-segment osteotomy between maxillary lateral incisors and canines bilaterally. Authors hypothesized that the 3-piece would provide better bone expansion. Study Design: A pilot study was conducted; 19 patients were divided into two groups: conventional 2-segment osteotomy (ten patients) and 3-segment osteotomy (nine patients). Dental and skeletal measurements of the preoperative and postoperative cone beam computed tomography images were analyzed. Pre and post-operative periodontal probing were performed, patients` cosmetic perception was evaluated in a colored visual analogue scale, and surgical time was measured with a regular chronometer. Results: Three segment surgically assisted rapid maxillary expansion the resulted in greater bone expansion (5.12 mm vs. 6.20 mm - P = 0.016), less molar inclination (7.16 vs. 3.57 degrees - P = 0.028), better patient's cosmetic perception (3.13 vs 7.68 in a VAS - P = 0.000), and longer surgical time (43 vs 52 minutes - P = 0.026). Furthermore, the 2-segment group presented necrosis of 1 central incisor. Conclusion: Results suggest that 3 piece SARME is more effective for bone expansion of the maxilla.