Effects of minimally invasive surgical and miniscrew-assisted rapid palatal expansion (MISMARPE) on the nasal cavity and upper airway: a comparative cohort study

R M Bastos; O L Haas Junior; V Piccoli; B M da Rosa; R B de Oliveira; L M de Menezes

doi:10.1016/j.ijom.2024.03.012

Effects of minimally invasive surgical and miniscrew-assisted rapid palatal expansion (MISMARPE) on the nasal cavity and upper airway: a comparative cohort study

Int J Oral Maxillofac Surg. 2024 Apr 11:S0901-5027(24)00088-2. doi: 10.1016/j.ijom.2024.03.012. Online ahead of print.

Authors

R M Bastos¹, O L Haas Junior², V Piccoli³, B M da Rosa⁴, R B de Oliveira², L M de Menezes³

Affiliations

¹ Oral and Maxillofacial Surgery Service, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: rubensmartinsbastos@gmail.com.
² Oral and Maxillofacial Surgery Service, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
³ Department of Orthodontics, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
⁴ Department of Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.

PMID: 38609790
DOI: 10.1016/j.ijom.2024.03.012

Abstract

This study was performed to evaluate the impact on the upper airway and nasal cavity of a new minimally invasive surgical and miniscrew-assisted rapid palatal expansion (MISMARPE) technique for the treatment of adult patients with transverse maxillary deficiency, in comparison to surgically assisted rapid palatal expansion (SARPE). Computed tomography scans of 21 MISMARPE and 16 SARPE patients were obtained preoperatively (T0) and at the end of the activation period (T1) and analysed. Linear and volumetric measurements were performed in the dental, alveolar, nasal cavity, and oropharynx regions. Generalised estimating equations were used to consider the intervention time and surgery type, and their interaction. In both groups, measurements were increased at T1 (P < 0.001), except for oropharynx volume (P > 0.05). A greater expansion in nasal cavity floor and median palatal suture was shown for MISMARPE when compared to SARPE (P < 0.001), with the same degree of expander activation (P = 0.094). A trapezoidal (coronal plane) and 'V' shape (axial plane) expansion pattern, was observed after MISMARPE. Both surgical techniques were effective for maxillary expansion in adults. However, MISMARPE was performed without osteotomy of the pterygomaxillary suture, in an outpatient setting and with local anaesthesia.

Keywords: Airway remodelling; Dentofacial deformities; Minimally invasive surgical procedures; Nasal cavity; Palatal expansion technique.