Case Report

Treatment of severe crowding and a narrow maxilla with surgically assisted rapid maxillary expansion (SARME) : A case report


  • Gökhan Serhat Duran
  • Alaattin Tekeli
  • Serkan Görgülü
  • Sıla Mermut Gökçe
  • Hasan Ayberk Altuğ

Received Date: 11.05.2016 Accepted Date: 04.08.2017 Gulhane Med J 2017;59(2):49-52

The aim of this case report is to present an adult patient with a narrow maxilla and severe crowding treated with the help of surgically assisted maxillary expansion. A 17-year-old male patient referred to our clinic for the primary complaint of unaesthetic smile and severe upper anterior crowding. Extraoral examination revealed convex profile. Intraoral examination revealed narrow maxilla, posterior cross bite, V shaped upper arch form and severe crowding. The treatment was initiated with corticotomy operation for maxillary expansion. A tooth-borne acyrilic cap splint appliance with Hyrax screw was then fixed for distraction. Distraction protocol was started 7 days postoperatively by 2 turns a day (0.5 mm/ day). The distractor was left in place for an additional 3 months for stabilization and reossification after the required space had been achieved. Orthodontic fixed treatment started within 4 weeks after removal of the appliance. Computed tomography scans of the patient were performed to help the planning of the treatment 1 month before the orthodontic treatment. The data reconstructed using the Mimics software (Materialise, Leuven, Belgium) for surgical planning. Surgically assisted maxillary expansion is a successful treatment modality for adult patients requiring palatal expansion. The total treatment period was 24 months and the results were acceptable.

Keywords: SARME, Surgical assisted rapid maxillary expansion ,palatal expansion.