History
- Orthodontic expansion first described by Emersen Angell about 145 years ago
- Kole in 1959 first person to speak about corticotomy procedure in adults with maxillary constriction
- Brown first described surgical technique for SARPE in 1938
- Steinhauser first described technique involving segmental left/right split of maxilla along with placement of graft in 1972

Indications
- Skeletal maturity or adult patients
- Fused intermaxillary suture
- Transverse maxillary hypoplasia
- Bilateral posterior crossbite
- Previous failure of use of any other expansion devices

Procedure
- SARPE performed to address transverse dimension changes in a patient
- Surgery followed by Le Fort 1 in a second surgery to address vertical and anterior-posterior changes
- Rapid maxillary expander device placed in maxilla for first surgery
- Le Fort fracture of skull without downfracture of maxilla performed under local anesthesia and iv sedation or general anesthesia
- Midpalatal osteotomy performed to allow break in inter-maxillary suture

Stability of Procedure
- Chamberland and Profitt observed skeletal changes of about 3-4mm after SARPE, which were stable
- One-third of transverse dental expansion obtained with SARPE may be lost, but skeletal expansion remains the same
- Post-surgical relapse with SARPE similar to changes in dental arch dimensions after non-surgical rapid palatal expansion
- Stability of procedure not superior to other known expansion techniques
- Study by Northway et al. suggested long-term buccogingival expansion more acceptable in adults expanded with surgical augmentation

Disadvantages
- Unaesthetic period after expansion with RME
- Implementation of palatal expander post-operatively
- Patient compliance necessary
- Second surgery likely

[REFERENCES]
- Koudstaal, M. J.; Poort, L. J.; van der Wal, K. G. H.; Wolvius, E. B.; Prahl-Andersen, B.; Schulten, A. J. M. (2005). Surgically assisted rapid maxillary expansion (SARME): a review of the literature.
- Catalog of Copyright Entries. Part 1. A Group 1. Books. New Series. 1938.
- Steinhauser, E. W. (1972). Midline splitting of the maxilla for correction of malocclusion.
- Hamedi Sangsari, Adrien; Sadr-Eshkevari, Pooyan; Al-Dam, Ahmed; Friedrich, Reinhard E.; Freymiller, Earl; Rashad, Ashkan (2016). Surgically Assisted Rapid Palatomaxillary Expansion With or Without Pterygomaxillary Disjunction: A Systematic Review and Meta-Analysis.
- Chamberland, Sylvain; Proffit, William R. (2016). Short-term and long-term stability of surgically assisted rapid palatal expansion revisited.
- Chamberland, Sylvain; Proffit, William R. (2016). Closer Look at the Stability of Surgically Assisted Rapid Palatal Expansion.
- Northway, W. M.; Meade, J. B. (1997). Surgically assisted rapid maxillary expansion: a comparison of technique, response, and stability.

Surgically assisted rapid palatal expansion (SARPE), also known as surgically assisted rapid maxillary expansion (SARME), is a technique in the field of orthodontics which is used to expand the maxillary arch. This technique is a combination of both Oral and Maxillofacial Surgery and Orthodontics. This procedure is primarily done in adult patients whose maxillary sutures are fused and cannot be expanded via other techniques.

Surgically assisted rapid palatal expansion
Other namesSurgically assisted rapid maxillary expansion, SARPE, SARME
SpecialtyOral and maxillofacial surgery, Orthodontics
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