Surgically Assisted Rapid Maxillary Expansion: surgical and orthodontic aspects

The scope of this thesis is to shed more light, from a number of perspectives, on surgically assisted rapid maxillary expansion (SARME). The primary questions this thesis set out to answer were; ‘is there a difference in stability between bone-borne and tooth-borne distraction?’ and ‘can a relationship be found between segmental maxillary tipping, relapse, and the mode of distraction?’ Secondary questions were; ‘what is the influence of surgically assisted rapid maxillary expansion on the nasal airway and the nasalance of speech?’ and ‘what is the effect of surgically assisted rapid maxillary expansion on the upper facial appearance?’ The thesis is divided into five Parts. Part I consists of the general introduction, a review of the literature on SARME (Chapter 1). No consensus could be found regarding the surgical technique, the type of distractor used (tooth-borne or bone-borne), the existence, cause and amount of relapse, and whether or not overcorrection is necessary. Furthermore, relapse is widely recognized yet poorly explicated. A wide variety of techniques and methods to correct transverse maxillary hypoplasia is currently used without underlying scientific basis.