An evaluation of three-dimensional facial changes after surgically assisted rapid maxillary expansion (SARME)

Abstract Background: The purpose of the study was to evaluate the three-dimensional (3D) facial changes following surgically assisted rapid maxillary expansion (SARME). In 15 skeletally mature patients with maxillary transverse deficiency the planned maxillary expansion (on average 8.8 mm ± 2.3 mm) was achieved with bone-borne palatal distractor. The 3D optical scans of the facial surface were obtained before and 6 months after SARME and compared with cephalometric and regional analysis to evaluate the soft-tissue changes. Findings. The largest differences between the pre- and post-operation scans were observed for the paranasal and cheek area (1.4 ± 1.0 mm) in the lateral direction with a soft-to-hard tissue ratio of 0.22. Significant differences occurred for an increased nasal width, a decreased upper-face height with an unchanged lower height, an increased vertical philtrum height and an increased nasolabial angle. A significant increase in the facial profile angle was also observed, resulting in an increased facial convexity and anterior displacement of the upper-lip area. Conclusions. We have confirmed the widening of the nose and increased projection in the cheek and paranasal area in the lateral direction after maxillary expansion, while we found facial convexity increases, reflecting the underlying advancement of the maxilla.

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Three-dimensional evaluation of soft tissue changes in the orofacial region after tooth-borne and bone-borne surgically assisted rapid maxillary expansion

Clinical Oral Investigations ◽

10.1007/s00784-013-0927-1 ◽

2013 ◽

Vol 17 (9) ◽

pp. 2017-2024 ◽

Cited By ~ 13

Author(s):

Rania M. Nada ◽

Bram van Loon ◽

Thomas J.J. Maal ◽

Stefaan J. Bergé ◽

Yehya A. Mostafa ◽

...

Keyword(s):

Soft Tissue ◽

Three Dimensional ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Orofacial Region ◽

Tissue Changes ◽

Soft Tissue Changes

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Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

Materials ◽

10.3390/ma14051152 ◽

2021 ◽

Vol 14 (5) ◽

pp. 1152

Author(s):

Rafał Nowak ◽

Anna Olejnik ◽

Hanna Gerber ◽

Roman Frątczak ◽

Ewa Zawiślak

Keyword(s):

Finite Element Analysis ◽

Finite Element ◽

Three Dimensional ◽

Element Model ◽

Rapid Maxillary Expansion ◽

Stress Distributions ◽

Maxillary Expansion ◽

Facial Skeleton ◽

Element Analysis ◽

Maxillary Constriction

The aim of this study was to compare the reduced stresses according to Huber’s hypothesis and the displacement pattern in the region of the facial skeleton using a tooth- or bone-borne appliance in surgically assisted rapid maxillary expansion (SARME). In the current literature, the lack of updated reports about biomechanical effects in bone-borne appliances used in SARME is noticeable. Finite element analysis (FEA) was used for this study. Six facial skeleton models were created, five with various variants of osteotomy and one without osteotomy. Two different appliances for maxillary expansion were used for each model. The three-dimensional (3D) model of the facial skeleton was created on the basis of spiral computed tomography (CT) scans of a 32-year-old patient with maxillary constriction. The finite element model was built using ANSYS 15.0 software, in which the computations were carried out. Stress distributions and displacement values along the 3D axes were found for each osteotomy variant with the expansion of the tooth- and the bone-borne devices at a level of 0.5 mm. The investigation showed that in the case of a full osteotomy of the maxilla, as described by Bell and Epker in 1976, the method of fixing the appliance for maxillary expansion had no impact on the distribution of the reduced stresses according to Huber’s hypothesis in the facial skeleton. In the case of the bone-borne appliance, the load on the teeth, which may lead to periodontal and orthodontic complications, was eliminated. In the case of a full osteotomy of the maxilla, displacements in the buccolingual direction for all the variables of the bone-borne appliance were slightly bigger than for the tooth-borne appliance.

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A Perioral Soft Tissue evaluation after Orthognathic Surgery Using Three-Dimensional Computed Tomography Scan

The Open Dentistry Journal ◽

10.2174/1874210601812010366 ◽

2018 ◽

Vol 12 (1) ◽

pp. 366-376

Author(s):

Rahul Tiwari ◽

P. Srinivas Chakravarthi ◽

Vivekanand S. Kattimani ◽

Krishna Prasad Lingamaneni

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Orthognathic Surgery ◽

Soft Tissues ◽

Three Dimensional ◽

Computed Tomography Scan ◽

Nasolabial Angle ◽

Tissue Changes ◽

Soft Tissue Changes ◽

Tomography Scan

Background: Facial appearance is an important factor, affects social and psychological well-being. The ideal positioning of jaws and soft tissues is crucial during orthognathic surgery for a better outcome, but the response of facial soft tissues does not always reflect the exact movements of the underlying jaws in 1:1 ratio. So, soft tissue changes following orthognathic surgery require utmost attention during surgical correction to make successful treatment. Aims and Objectives: Evaluation of perioral soft tissue changes after orthognathic surgical procedures. The objectives of the study were to assess and compare pre and post-operative perioral soft tissue changes of lip width, nasolabial and mentolabial angle using Three Dimensional Computed Tomography scan (3DCT). Patient and Methods: The study involved ten patients for evaluation requiring orthognathic surgical procedures (maxillary or mandibular anteroposterior excess or deficiency, transverse deformities, vertical maxillary excess and facial asymmetry) presented to the department of oral and maxillofacial surgery during 2014-2016. Pre and post-operative 3DCT scan were taken after 12 months using iCT 256 slice whole body CT scanner and evaluated for changes using Dicom PMS D view. Results: Significant changes were observed in nasolabial angle after maxillary advancement (1.81°) and maxillary setback procedure (2.73°). The mentolabial angle was significantly increased with mandibular setback procedures (3.27°). Mandibular advancement procedures showed both increase (3.6°) and decrease (7.6°) in mentolabial angle. Conclusion: 3DCT showed a significant difference in perioral soft tissue changes in nasolabial and mentolabial angle but no significant change was observed in lip width. 3DCT is a reliable tool for 3D assessment. The conventional thought of changes in Nasolabial angle after surgery is changing due to the underlying factors which should be considered for prediction.

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Facial soft tissue changes after nonsurgical rapid maxillary expansion: a systematic review and meta-analysis

Head & Face Medicine ◽

10.1186/s13005-018-0162-8 ◽

2018 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Jing Huang ◽

Cui-Ying Li ◽

Jiu-Hui Jiang

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Meta Analysis ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Facial Soft Tissue ◽

Tissue Changes ◽

Soft Tissue Changes

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Effects of Rapid Maxillary Expansion and Facemask Therapy on the Soft Tissue Profiles of Class III Patients at Different Growth Stages

European Journal of Dentistry ◽

10.1055/s-0039-1694799 ◽

2019 ◽

Vol 13 (02) ◽

pp. 143-149

Author(s):

Fatma Selen Ozzeybek Can ◽

Hakan Turkkahraman

Keyword(s):

Soft Tissue ◽

Repeated Measures ◽

Treatment Options ◽

Rapid Maxillary Expansion ◽

Growth Stages ◽

Class Iii ◽

Maxillary Expansion ◽

Treatment Groups ◽

Facial Changes ◽

Different Growth Stages

Abstract Objectives The aim of this study was to evaluate the effects of rapid maxillary expansion (RME) and facemask therapy on the soft tissue profiles of class III patients at different growth stages. Materials and Methods Forty-five subjects (23 females and 22 males) were divided into prepubertal, pubertal, and postpubertal groups. Bonded type RME appliances and Petit-type facemasks were fitted to each patient, and intraoral elastics were applied from the hooks of the RME appliance to the facemask. Statistical Analysis All measurements were statistically analyzed with SPSS version 18.0 (SPSS Inc., Chicago, IL, United States) for Windows. Repeated-measures of ANOVA and posthoc Tukey tests were used to compare the groups. Results The soft tissue nasion, pronasale, subnasale, soft tissue A point, and labrale superior landmarks were all displaced forward and downward, and the most dramatic changes were recorded in the pubertal group. The labrale inferior, soft tissue B point, soft tissue pogonion, and soft tissue menton landmarks moved backward and downward in all groups, and the greatest displacements were observed in the pubertal group. Conclusions The soft tissue profiles improved significantly and became more convex in all treatment groups. Although, the most favorable facial changes were observed in the pubertal growth stage, the treatments applied in the postpubertal stage also elicited significant changes and should thus be considered viable treatment options.

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