Surgically assisted rapid palatal expansion vs. segmental Le Fort I osteotomy: Transverse stability over a 2-year period

Introduction: We compared the long-term stability of surgically assisted rapid palatal expansion (SARPE) and segmental Le Fort I osteotomy (bipartition) for expanding the maxillae in adult patients. Methods: The upper jaw plaster models of 10 patients who underwent transverse expansion of the maxillae using the SARPE technique and 10 patients who underwent Le Fort I bipartition were examined. For each patient, the intercanine and intermolar distances before expansion (T1), after expansion (T2), and 2 years after expansion (T3) were measured. Consequently, we could evaluate the degree of expansion (between T1 and T2) and the relapse distance after 2 years (between T2 and T3). The palatal stability (i.e., extent of relapse) was used to assess the outcomes in both methods. Results: In the SARPE group, the average increase in the intercanine and intermolar distance was +8.5 and +7 mm, respectively. In the Le Fort I bipartition group, the average respective increase was +2.75 and +3.75 mm. Two years after expansion, in the SARPE group, the intercanine distance decreased by 2.5 mm or 28% of the overall expansion, and the intermolar distance decreased by 3.0 mm or 36% of the overall expansion. In the Le Fort I bipartition group, the intercanine distance decreased by 0.25 mm or 25% of the overall expansion, and the intermolar distance decreased by 0.75 mm or 20% of the overall expansion. Conclusions: In the patients that we assessed, there was a high relapse rate in the mean intercanine and intermolar distances 2 years following the expansion. The overall relapse rate was more pronounced in the SARPE patients, whereas the Le Fort I bipartition technique was more stable, especially in terms of the intermolar distance. (c) 2008 European Association for Cranio-Maxillofacial Surgery