“What is the ‘SARPE’ Procedure?”

1.31.24 Quick Review #100 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency Surgically Assisted Rapid Palatal Expansion (SARPE) is a combined orthodontic and surgical procedure aimed at widening a narrow maxilla. This is achieved by surgically cutting the bone of the palate to facilitate its separation, allowing for the insertion of a device that gradually widens the space by applying outward pressure. Indications: • Skeletal Maturity: Adults with fused palatal sutures where conventional expanders are ineffective. • Narrow Upper Jaw: Insufficient width of the maxilla causing dental crowding, crossbites, or other occlusal issues. • Airway Issues: Narrow upper jaw contributing to restricted nasal airway passages and associated breathing problems. Pros: • Effective Expansion: Allows for significant widening of the upper jaw, which might not be achievable with orthodontic treatments alone. • Improved Occlusion: Can correct crossbites and improve the fit of upper and lower teeth. • Aesthetic Improvements: Enhances facial symmetry and aesthetics by expanding the upper jaw. • Potential Airway Benefits: May improve nasal airway breathing by increasing the width of the nasal cavity. Cons: • Surgical Risks: Like any surgical procedure, SARPE carries risks such as infection, bleeding, or adverse reactions to anesthesia. • Recovery Time: The initial surgical recovery and the subsequent period of palatal expansion require time and can involve discomfort. • Relapse Potential: There’s a risk of some degree of relapse, where the expansion achieved may partially decrease over time without proper retention. • Cost and Commitment: SARPE can be costly and requires a commitment to follow-up orthodontic treatment for optimal results. Complications: • Infection: As with any surgery, there’s a risk of infection at the surgical site. • Relapse: Some amount of relapse or narrowing of the expanded arch may occur after the removal of the expansion device. • Root Resorption: There is a small risk of root resorption of adjacent teeth due to the forces applied during expansion. References: 1. AO Foundation. (n.d.). AO Surgery Reference. Retrieved from https://surgeryreference.aofoundation.org/ 2. Smith, J.A., & Johnson, L.B. (2021). Expanding Horizons: A Comprehensive Review of Surgically Assisted Rapid Palatal Expansion. Journal of Oral and Maxillofacial Surgery, 79(2), 321-333. 3. Lee, H.C., Rodriguez, J.M., & Michaels, G.T. (2019). Airway Changes Following Surgically Assisted Rapid Palatal Expansion: A Systematic Review. American Journal of Orthodontics and Dentofacial Orthopedics, 156(3), 305-313. 4. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. (Eds.). (2022). Peterson’s Principles of Oral and Maxillofacial Surgery (4th ed.). Springer. 5. ChatGPT. 2024.