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

Abstract

Background The abnormal facial features in maxillary transverse deficiency (MTD) are minimal and limited to a deficiency of the middle facial third, narrow nares and nasal base, and deepened nasolabial folds. The surgical expansion of the narrow maxilla has most obvious effects on widening of the maxillary dental arch and expansion of the maxillary and palatal structures in the transverse plane, however sagittal changes also occurs. The purpose of this observational study was to evaluate the three-dimensional (3D) facial soft tissue changes following surgically assisted rapid maxillary expansion (SARME). Methods In 15 skeletally mature patients with severe maxillary transverse deficiency, the planned maxillary expansion (on average 8.8 mm ± 2.3 mm) was achieved with a bone-borne palatal distractor. The 3D optical scans of the facial surface were obtained before and six months after SARME. In the first part, we defined different anatomical landmarks on both scans and compared cephalometric measurements. In the second part, we registered both 3D scans in the same workplace using the regional best-fit method (forehead, supraorbital and nasal root regions were selected for the superimposition) and conducted surface analysis. Results The largest differences between the pre- and post-operation scans were observed in the paranasal and cheek area (1.4 ± 1.0 mm). 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 The widening of the nose and increased projection in the cheek and paranasal area in the lateral direction after maxillary expansion were confirmed; moreover, facial convexity increases, reflecting the underlying advancement of the maxilla.

Rapid maxillary expansion treatment increases mid-facial depth in early mixed dentition

“…The abnormal facial features of transversal maxillary deficiency include a deficiency of the mid-face and deepened nasolabial folds ( 21 ). Also, the effects of maxillary expansion were limited not only to the maxilla but also to the surrounding facial region.…”

Tracking and recording the lip dynamics for the integration of a dynamic virtual patient: A novel dental technique

“…Facial scanning methods can be used to assess facial changes obtained by a specific treatment, such as maxillofacial surgery or removable prostheses. [28][29][30][31] The described technique might not be able to accurately reproduce profile changes that a prosthodontic treatment can achieve. Artificial intelligence (AI) models have been described for predicting facial changes in patients with removable dentures.…”

“…Facial scanning methods capture the 3D surface of the patient's face. Facial scanning methods can be used to assess facial changes obtained by a specific treatment, such as maxillofacial surgery or removable prostheses 28–31 . The described technique might not be able to accurately reproduce profile changes that a prosthodontic treatment can achieve.…”

Evaluation of dentoskeletal effects of surgically assisted rapid maxillary expansion using computed tomography

“…Previous studies using different methods (Betts et al, 1995;Betts & Lisenby, 1994;Garib et al, 2006) have confirmed that the effects of SARME are not seen only on the maxillary arch (Haas, 1961), and that dental changes (Starnbach et al, 1966) may also be expected. Facial soft tissue also changes after maxillary expansion, such as widening of the nose and increased projection in the cheek (Zupan et al, 2022). Zupan et al (2022).…”

“…Facial soft tissue also changes after maxillary expansion, such as widening of the nose and increased projection in the cheek (Zupan et al, 2022). Zupan et al (2022). An evaluation of three-dimensional facial changes after surgically assisted rapid maxillary expansion (SARME): an observational study.…”