A Simple Method to Treat Asymmetric Expansions in Three-Segment Surgically Assisted Rapid Maxillary Expansion

摘要: Surgically assisted rapid maxillary expansion (SARME) is a well-documented and established procedure indicated to treat transverse deficiencies in the adult patient. Currently, most popular SARME technique consists of performing Le Fort I osteotomy without downfracture midline that splits maxilla into 2 halves between central incisors. It supposed expand equally during activation phase. However, after completion osteotomies, expander supported by only mobile segments; thus, if 1 side remains more resistant than other, less expands resulting asymmetric maxilla. When this complication occurs SARME, an open revision surgery necessary remove bone interferences prevent movement on segment or create resistance other half. An alternative above apical roots, similar osteotomy, bilateral transalveolar osteotomies lateral incisors canines, dividing 3 segments: fixed containing segments are expanded. Some advantages 3-segment have been described, such as esthetic compromise from diastema, dental papilla compromise, preservation nasopalatine bundle, greater acceptance procedure. This article describes another advantage SARME: possibility expansions with easy conservative technique.