Dental and Medical Problems
2018, vol. 55, nr 4, October-December, p. 371–378
Publication type: original article
Volumetric upper airway changes following a new technique for Surgically-Assisted Maxillary Expansion (SAME)
Zmiany objętościowe górnych dróg oddechowych po zastosowaniu nowej techniki wspomaganego chirurgicznie poszerzania szczęki
1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Damascus University, Syria
2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
3 Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Medicine, Damascus University, Syria
Background. Skeletal maxillary constriction (SMC) is one of the common skeletal discrepancies which are associated with alterations in the respiratory function. Today, many surgical techniques are used to expand the maxilla in adult patients with no consensus about the optimal technique.
Objectives. The present study aimed to investigate the changes of the upper airway volume resulting from the use of a new, minimally invasive surgically-assisted maxillary expansion (SAME) technique, and compare the results with the conventional SAME technique.
Material and Methods. A prospective study was conducted between September 2015 and July 2018. A total of 28 adult patients (11 males, 17 females; mean age: 19.1 ±2.7 years) with SMC underwent SAME. The sample was divided according to the applied surgical technique into 2 groups: the conventional osteotomy SAME (CO‑SAME) group consisted of 13 patients (18.7 ±2.2 years) and the selective osteotomy SAME (SO-SAME) group consisted of 15 patients (19.4 ±3.2 years). Cone beam computed tomography (CBCT) scans were initially obtained preoperatively (T1) and 3 months post expansion (T2). The upper airway was divided into 2 segments: retropalatal and retroglossal. The volume of each segment and the total airway volume (TAV) were assessed using the OnDemand3D® software.
Results. The total upper airway volume showed a significant increase after both CO‑SAME and SO-SAME (1.29 ±0.26 cc and 1.21 ±0.19 cc, respectively), with significant increases in retropalatal and retroglossal airway volumes (RPAV and RGAV) after both CO‑SAME and SO-SAME (RPAV – 0.73 ±0.10 cc and 0.83 ±0.10 cc, and RGAV – 0.56 ±0.23 cc and 0.38 ±0.23 cc, respectively). No significant differences were observed in the maxillary width (MW), TAV or RGAV between the 2 SAME techniques, whereas the increase in RPAV in the SO-SAME group was significantly greater than that of the CO‑SAME group.
Conclusion. The new, minimally invasive SAME technique was an effective procedure to increase MW and the upper airway volume.
skeletal maxillary constriction, surgically-assisted maxillary expansion (SAME), upper airway volume
szkieletowe zwężenie szczęki, wspomagane chirurgiczne poszerzanie szczęki, objetość górnych dróg oddechowych
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