Minimally invasive surgically assisted rapid palatal expansion: are pterygomaxillary disjunction and nasal septum disinsertion necessary?

This retrospective multicentre study investigated the effects of pterygomaxillary disjunction (PD) and nasal septum disinsertion (NSD) by comparing two minimally invasive bone-anchored surgically assisted rapid palatal expansion techniques in adult patients. The analysis focused on their impact on the nasal septum and the extent of palatal expansion. Forty patients were allocated to two groups: G1 (without PD and NSD) and G2 (with PD and NSD). The transverse opening pattern in the anterior and posterior regions, as well as changes in the position of the nasal septum, were evaluated using cone beam computed tomography images. Both groups showed significant anterior and posterior transverse gains (G1: 4.8 mm and 2.9 mm; G2: 5.7 mm and 3.8 mm; all P ≤ 0.001). There was no significant difference between the groups in anterior or posterior opening (P = 0.44, P = 0.20). Both groups showed slight nasal septum displacement, but without statistical relevance (linear: P = 0.099, P = 0.072; angular: P = 0.062, P = 0.16). Both techniques were effective in treating maxillary deficiency in adult patients. The study suggests that PD and NSD may not be essential steps to achieve adequate palatal expansion with minimally invasive surgeries.