Evaluation of surgically assisted rapid maxillary expansion with and without midpalatal split.

The purpose of this study was to compare the efficacy and the patients' subjective symptomatology between surgically assisted rapid maxillary expansion (SARME) with midpalatal split and SARME without midpalatal split. The sample consisted of 24 consecutive adult patients requiring treatment with SARME, who were divided into two groups. Group 1 patients (n=14) underwent SARME with midpalatal split, and group 2 patients (n=10) underwent SARME without midpalatal separation. The efficacy of the technique was assessed in relation to the presence of a diastema between the upper incisors and radiographic evidence of separation of the maxillary bones in the midpalatal suture. The patients' symptomatology was evaluated using pain scores. The results demonstrated a greater efficacy for group 1 (P=0.00). The discomfort of surgery assessed immediately postoperative and at 14 days postoperative was similar in the two groups. Both surgical techniques were tolerated by the patients; the midpalatal separation did not influence patient discomfort due to surgery. The two groups showed a statistically significant difference regarding discomfort during appliance activation and pain during the postoperative phase, with group 2 showing greater discomfort.

Clinical evaluation of the effects of radiographic distortion on the position and classification of mandibular third molars.

OBJECTIVE: Panoramic radiographs are routinely employed for surgical planning of unerupted third molars. The objective of this study was to evaluate distortions in the position of mandibular third molars on panoramic radiographs. MATERIALS AND METHODS: Panoramic radiographs of 14 patients with indication for extraction of the mandibular third molars were used. Transurgical impressions of the crowns of the teeth to be extracted and adjacent second molars (n=19) were achieved with addition silicone and poured with type IV plaster for comparison of the inclinations of the third molars on the radiographs and study casts. RESULTS: There was a mean difference of -5.37 degrees between the position of the third molar on the panoramic radiograph and on the study cast (standard deviation 1.46, P<0.05, Student's t-test). CONCLUSION: There is distortion in the position of teeth on the panoramic radiograph, which may influence the surgical planning; however, this does not invalidate it as the main tool for diagnosis and surgical planning of mandibular third molars.