Complications following one-stage versus two-stage surgical treatment of transverse maxillary hypoplasia

Abstract Purpose Contemporary literature suggests a similar transverse stability of a surgical-assisted rapid palatal expansion (SARPE) and a segmented Le Fort I osteotomy. The aim of this study is to compare postoperative complications of 1-stage (segmental maxillary osteotomy) and 2-stage (SARPE followed by Le Fort I osteotomy) treated patients to determine the preferred treatment strategy. Methods This retrospective study included 74 consecutive patients (age range: 14 – 57 years; 36 males, 38 females) with a moderate transverse maxillary hypoplasia: 32 patients were treated in a 1-stage and 42 in a 2-stage protocol with a postoperative follow-up of at least 1 year. Dental complications such as loss of teeth, gingival dehiscence, periodontal bone loss, apical root resorption, and surgical complications such as pain, hemorrhage, altered neurosensitivity, wound infection, aseptic necrosis were analyzed. Univariate analysis consisted of a generalized linear model with logit link or Fisher exact test. Results No significant difference was found for group characteristics except for longer orthodontic treatment time in the 2-stage group. Incidence and severity of complications were comparable for the 1-stage and 2-stage patients. Only overall pain was significantly greater in the 2-stage patient group (P=0.038). Conclusion Considering a similar complication rate and transversal stability, the choice between 1-stage and 2-stage approach for patients with a moderate transverse maxillary hypoplasia should be patient-specific.