Author Topic: Simultaneous SARME and le fort 1 now possible  (Read 801 times)

sean89

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Simultaneous SARME and le fort 1 now possible
« on: April 13, 2015, 12:19:45 PM »
I've seen people ask this question a few times, and the traditional way of correcting transverse and sagittal maxillary discrepancies was the segmental le fort procedure. The upper jaw could be segmented in many different ways, differing according to the preference of the surgeon. Unless a midline osteotomy was being performed, premolar extractions were usually performed so as to provide the surgeon enough room to cut between the roots. The segmental le fort usually widened the back of the arch more than the front and is limited to 7/8mm arch discrepancies.

With the emergence of SARME and distraction osteogenesis, the expander is usually fitted at the same time as wisdom or premolar extractions are done because it was thought to be impossible to expand the maxilla via DO if the downfracture has been completed. For most people, this will be enough and there's no need for change.

Recently, though, there's an Italian surgeon called Antonio Cortese who (apparently) has worked out a technique to do both a le fort 1 and SARPE at the same time. He's published research about this and the history of SARPE/Le Fort which I've come across which made me write the above. You should find these papers if, for whatever reason, a two step approach is unnecessary i.e. gummy smile correction and arch widening.

sean89

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Re: Simultaneous SARME and le fort 1 now possible
« Reply #1 on: April 13, 2015, 01:47:25 PM »
What do you mean?

SARME widens everywhere. Segmental le fort tends to widen the back substantially more than the front.