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

Objective: To compare the 2 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 2 groups: conventional 2-segment osteotomy (10 patients) and 3-segment osteotomy (9 patients). Dental and skeletal measurements of the preoperative and postoperative cone beam computed tomography images were analyzed. Pre- and postoperative periodontal probing was performed, patients’ cosmetic perception was evaluated in a colored visual analog scale (VAS), and surgical time was measured with a regular chronometer. Results: Three-segment SARME resulted in greater bone expansion (5.12 vs 6.20 mm; P = .016), less molar inclination (7.16 vs 3.57 degrees; P = .028), better patient cosmetic perception (3.13 vs 7.68 in a VAS; P = .000), and longer surgical time (43 vs 52 minutes; P = .026). Furthermore, the 2-segment group presented necrosis of 1 central incisor. Conclusions: Results suggest that 3-piece SARME is more effective for bone expansion of the maxilla.