Overview of Surgical Treatment for Maxillary Constriction

IntroductionThe general indications for surgically assisted rapid maxillary expansion (SARME) are skeletal maturity, (extreme) transverse maxillary hypoplasia, either unior bilateral, anterior crowding and buccal corridors, the so called black corridors, when smiling. Furthermore the indications for SARME include any case where orthodontic maxillary expansion has failed and resistance of the sutures must be overcome. Transverse maxillary hypoplasia, in adolescents and adults, is frequently seen in non-syndromal and syndromal patients including cleft patients. In skeletally matured patients the unior bilateral transverse hypoplasia can be corrected by means of SARME. The treatment is a combination of orthodontics and surgical procedures and provides dental arch space for alignment of teeth. The procedure also causes a substantial enlargement of the maxillary apical base and of the palatal vault, providing space for the tongue for correct swallowing and thus preventing relapse. In addition, a distinct subjective improvement in nasal breathing associated with enlargement of the nasal valve towards normal values is seen with an increase of nasal volume in all compartments.