Evaluation of two different rapid maxillary expansion surgical techniques and their effects on the malar complex based on 3d cone-beam computed tomography.

We compared and evaluated the effects of two techniques used for surgically assisted rapid maxillary expansion (SARME) using three-dimensional (3D) cone-beam computed tomography, focusing on changes in soft and hard tissue in the malar region. A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years) underwent 3D analyses. Changes in hard and soft tissue of the malar region were compared. The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1.43 ± 1.23 and 1.39 ± 1.19 mm, respectively. The average increases in the bone malar depth on the right and left sides in the high Le Fort I group were 1.34 ± 0.81 and 1.60 ± 0.54 mm, respectively. Progress in hard tissues did not reflect significant changes in soft tissue. CONTEXT: Effects of high Le Fort I SARME on the malar complex. AIMS: To compare and evaluate the effects of two techniques used for SARME, using 3D cone-beam computed tomography, focusing on changes in hard and soft tissues in the malar region. SETTINGS AND DESIGN: A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years). METHODS AND MATERIAL: Each group underwent 3D analyses, and changes in hard and soft tissues of the malar region were compared. STATISTICAL ANALYSIS USED: The SPSS software (ver. 15.0 for Windows) was used. The Kolmogorov-Smirnov test, Student's t test, and paired-samples test were conducted. RESULTS: The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1.43 ± 1.23 and 1.39 ± 1.19 mm, respectively. The average increases in the bone malar depth on the right and left sides in the high Le Fort I group were 1.34 ± 0.81 and 1.60 ± 0.54 mm, respectively. CONCLUSIONS: Progress in hard tissues did not reflect significant changes in soft tissue.

Sliding malar bone augmentation technique with a high le fort I surgically assisted rapid maxillary expansion.

The purpose of this report is to evaluate the effectiveness of a high Le Fort I osteotomy design, including the malar bones, which allows segment sliding over the zygoma and forces the osteotomized segment to move forward with distraction. Two patients (male, 23-and 30-year-old) with malar deficiency underwent high Le Fort I osteotomy and surgically assisted rapid maxillary expansion procedure was followed. Records were taken before and 6 months after surgery for comparison, including intra and extra oral photographs and three-dimensional cone-beam computed tomography (CBCT) images. The bone malar width and bone malar depth changings in malar region were evaluated. Preoperative and postoperative CBCT images and clinical views of the patients showed forward movement of the malar region.