This retrospective cohort study investigated the effects of rapid maxillary expansion on the soft tissues using CBCTs. The sample consisted of 60 subjects: experimental group (n=30, treated with rapid maxillary expansion (RME), age:10.93 ± 2.20) and control group (n=30, age 11.43 ± 2.8). Soft tissue measurements were made using soft tissue landmarks. Paired t-test was used to compare the changes after expansion, and student t-test was used to compare the experimental and the control group. Intraclass correlation coefficient was used to evaluate intra-examiner reliability. Statistically significant differences were noted when comparing the experimental to the control group in transverse and anterior posterior dimensions. Increase was noted at the bialar distance (0.90mm, p=0.0363), nostril medium left to midsagittal plane (0.75mm, p=0.0423), the angle of pronasale to nostril base right and left (1.640, p<.001), columella width (0.56mm, p=0.0272), nostril base left to midsagittal plane, (1.03mm, p=0.0207), chelion right to endocanthus right (1.57mm, p=0.0086), chelion left to endocanthus left (1.96mm, p=0.0015). Anteroposteriorly, the tip of the nose moved forward (pronasale to coronal plane (1.97mm, p=0.0018), nostril medium right to coronal plane (1.07mm, p=0.0486), alare right to coronal plane (1.67mm, p=0.0117), pronasale to nostril base left (2.24mm, p<0.001) and right (2.12mm, p<0.001). Finally comparing genders, all the measurements were significantly greater in males compared to females except for columella width. In conclusion, RME influences soft tissue changes of the face, specifically in the nasal area. The base of the nose, bialar distance and columella widened while the tip of the nose moved forward.

Background: Maxillary expansion has long been used in children and adolescents for transverse discrepancies and dental crowding. With age, the mid-palatal suture becomes increasingly mature, requiring heavy, rapid force in order to achieve skeletal expansion. As an individual grows into adulthood, it has been demonstrated that a skeletally anchored expander can be used in order to achieve successful sutural separation. The side effects between these two types of expanders, including dental tipping with relative extrusion of buccal segments and clockwise mandibular rotation, have been demonstrated to have differences in their degrees of severity. However, most of the studies have evaluated the effects immediately following the expansion and not through a prolonged period in which growth may occur. The purpose of the present study was to investigate long-term skeletal differences in two types of expansion (RPE vs MARPE) on a growing population. Methods: This retrospective study included 39 adolescent subjects (mean age = 13.8 years) who had received maxillary expansion (20 RPE, 19 MARPE) with subsequent completion of orthodontic treatment. Initial and final CBCTs were used to analyze cephalometric and transversal changes between the two groups. Transverse measurements were repeated two weeks apart to test intra-observer reliability. Results: Cephalometric analysis demonstrated no significant differences in changes of FMA (p = 0.549) or MP-SN (p = 0.722) between the two groups following expansion and completion of orthodontic treatment. There were statistically significant differences in transverse changes between the two groups, with the MARPE group displaying more skeletal expansion. Conclusions: The results of the present study suggest that skeletally anchored expander - MARPE and conventional expander have similar skeletal effects in adolescents.

Introduction: When skeletal transverse discrepancies exist between the maxilla and mandible, they commonly manifest in dental malocclusion. If left uncorrected, the malocclusion can lead to periodontal issues, tooth fractures, tooth loss, or other significant dental problems. Utilization of microimplants in palatal expansion aims to correct transverse discrepancies between the maxilla and mandible by separating the palatal suture in a parallel manner aimed at maximizing skeletal changes and minimizing dental side effects. Overlying soft tissue changes can be affected by the induced skeletal changes. The purpose of this study is to evaluate skeletal expansion and the overlying soft tissue change that occurs using MARPEs (microimplant assisted rapid palatal expanders) at the end of orthodontic treatment in skeletally mature (Cervical Vertebral Maturation (CMV) ≥ 5) patients using cone-beam computed tomography (CBCT) imaging and to evaluate soft tissue changes that occur at the time of orthodontic treatment completion using CBCT imaging. Materials and Methods: CBCT scans from 19 patients who were treated using microimplant assisted rapid palatal expanders were traced and evaluated at three time points: Before orthodontic treatment (T1), post MARPE expansion with MARPE in place (T2), and after orthodontic treatment with MARPE removed. Fourteen hard tissue landmarks and six soft tissue landmarks in the midface and nasal cavity regions were traced by three judges at each time point. The traced landmark points were averaged among all three judges and comparisons were made between the three time points to see the amount of expansion that occurred at various anatomical 2 regions. Intraclass correlation coefficient (ICC) was used to evaluate inter-judge reliability for all measurements. A repeated measures ANOVA test was used for statistical comparison across all three time points and a Tukey post hoc test was used for comparison between time points. Significance was set to .05 and ICC was set to >.70. Results: Expansion with microimplant assisted rapid palatal expanders can affect the hard tissue of the midface region as well as the overlying soft tissue. Increases in skeletal width from the ANS down to the maxillary alveolar bone were statistically significant in both the short term (T1-T2) and long term (T1-T3). The nasal cavity width at inferior turbinate area increased significantly after expansion (T2) and remained increased at treatment completion (T3) and the increased soft tissue width of the alar base that presented after expansion therapy remained increased at treatment completion. Conclusion: Maxillary expansion with microimplant assisted expanders resulted in skeletal changes throughout the maxilla and led to a significant long-term increase in nasal cavity width. The soft tissue changes associated with MARPE treatment show that a widening of the base of the nose may be expected after expansion and can remain at treatment completion.

Nos dias atuais, uma significante parte da população nacional pode apresentar alterações da relação maxilo-mandibular, chamada de má oclusão. A principal alteração do crescimento facial encontrado nos adultos é a deficiência transversal da maxila. A correção desta deficiência é realizada por um procedimento cirúrgico denominado de expansão rápida da maxila cirurgicamente assistida. Estas cirurgias causam uma mudança na atividade muscular, principalmente naqueles músculos responsáveis pelo fechamento mandibular, no qual se destaca o músculo masseter. Estas alterações musculares duram em média 30 dias, quando clinicamente note-se a diminuição da força ou potencial muscular de fechamento mandibular. Verificam-se os efeitos da expansão rápida de maxila sobre os músculos masséteres dos pacientes, avaliando resultados obtidos por eletromiografia de superfície. Realizaram quatro avaliações, no 7° dia pré-operatório e no 7°, 30° e 60° dia pós-operatório, em 20 pacientes, durante a contração máxima voluntária isométrica sobre um rolete de algodão. Comprovou-se que a atividade do músculo apresentou diminuição no 7° dia pós-operatório para 13,7% da sua atividade inicial. Nos 30º e 60º dias após a cirurgia, observou-se a recuperação até 26,7% e 94,9% de sua atividade inicial, respectivamente. / Nowadays, a significant part of the national population presents alterations of the maxilomandibular relationship, denominated bad occlusion. The main alteration of the facial growth found in the adults is the transverse deficiency of maxillary. The correction of this deficiency is accomplished through a surgical procedure denominated. These surgeries cause a change in the muscular activity, mainly in those muscles responsible for closing mandible, in which stands out the masséter muscle. These muscular alterations last 30 days on average, where clinically it is noticed the decrease of the force or muscular potential of closing the jaw. This work evaluates, through the electromyography exam, the effects of the surgical assisted rapid maxillary expansion on the patients\' muscles masseters. Twenty patients were evaluated four times: 7 days before surgery; and 7, 30 and 60 days after surgery. The evaluation was done during the maximum voluntary isometric contraction on a cotton piece. The activity of the muscle diminished 7 days after surgery to 13, 7% of the initial activity. Nevertheless, 30 and 60 days after surgery, there was a recovery to 26, 7 and 94, 9%, respectively.

Nos dias atuais, uma significante parte da população nacional pode apresentar alterações da relação maxilo-mandibular, chamada de má oclusão. A principal alteração do crescimento facial encontrado nos adultos é a deficiência transversal da maxila. A correção desta deficiência é realizada por um procedimento cirúrgico denominado de expansão rápida da maxila cirurgicamente assistida. Estas cirurgias causam uma mudança na atividade muscular, principalmente naqueles músculos responsáveis pelo fechamento mandibular, no qual se destaca o músculo masseter. Estas alterações musculares duram em média 30 dias, quando clinicamente note-se a diminuição da força ou potencial muscular de fechamento mandibular. Verificam-se os efeitos da expansão rápida de maxila sobre os músculos masséteres dos pacientes, avaliando resultados obtidos por eletromiografia de superfície. Realizaram quatro avaliações, no 7° dia pré-operatório e no 7°, 30° e 60° dia pós-operatório, em 20 pacientes, durante a contração máxima voluntária isométrica sobre um rolete de algodão. Comprovou-se que a atividade do músculo apresentou diminuição no 7° dia pós-operatório para 13,7% da sua atividade inicial. Nos 30º e 60º dias após a cirurgia, observou-se a recuperação até 26,7% e 94,9% de sua atividade inicial, respectivamente. / Nowadays, a significant part of the national population presents alterations of the maxilomandibular relationship, denominated bad occlusion. The main alteration of the facial growth found in the adults is the transverse deficiency of maxillary. The correction of this deficiency is accomplished through a surgical procedure denominated. These surgeries cause a change in the muscular activity, mainly in those muscles responsible for closing mandible, in which stands out the masséter muscle. These muscular alterations last 30 days on average, where clinically it is noticed the decrease of the force or muscular potential of closing the jaw. This work evaluates, through the electromyography exam, the effects of the surgical assisted rapid maxillary expansion on the patients\' muscles masseters. Twenty patients were evaluated four times: 7 days before surgery; and 7, 30 and 60 days after surgery. The evaluation was done during the maximum voluntary isometric contraction on a cotton piece. The activity of the muscle diminished 7 days after surgery to 13, 7% of the initial activity. Nevertheless, 30 and 60 days after surgery, there was a recovery to 26, 7 and 94, 9%, respectively.

Introduction: L’expansion palatine du maxillaire a beaucoup d’effets positifs sur la respiration et la qualité du sommeil, mais peu d'études ont examiné ces données sur des adultes ayant dépassé l’âge permettant de bénéficier d'une expansion palatine conventionnelle. Le but de cette recherche est d’évaluer la stabilité de l’EPRAC (expansion palatine rapide assistée chirurgicalement) et son effet sur les troubles respiratoires après l’ablation des appareils orthodontiques. Méthodes: Neuf patients (Âge moyen 21, entre 16-39 ans) nécessitant une EPRAC ont passé des nuits dans un laboratoire de sommeil, et ce avant l’EPRAC, après l’EPRAC, et après l’ablation des appareils fixes. Les radiographies céphalométriques postéroantérieures ainsi que les modèles d’étude ont été pris pendant ces trois périodes de temps. Résultats: L’analyse des modèles d’étude a démontré une récidive significative au niveau des distances inter-molaires et inter-canines au niveau du maxillaire seulement. Les analyses céphalométriques ont démontré une récidive au niveau de la largeur maxillaire. Aucun changement important n'a été observé dans les stades de sommeil, mais une réduction importante dans l’index de ronflement a été notée. De plus, il y avait moins de changements entre les stades de sommeil. Conclusions: La récidive squelettique est minime et cliniquement non significative. Par contre, les changements dans les distances intermolaires et intercanines sont cliniquement importants. Il semble également qu'une EPRAC ait un effet positif sur la qualité de sommeil par la réduction de l’indice de ronflement ainsi que sur la diminution des changements entre les stades de sommeil. / Introduction: Orthopedic expansion appears to have several positive effects on respiration as well as sleep quality, but a lack of studies examine these findings using SARPE on skeletally mature individuals. The aim of this study was to evaluate post-SARPE stability as well as its effect on sleep disordered breathing after completing full fixed orthodontics. Methods: 9 patients (average age 21, range 16-39) requiring SARPE underwent polysomnographic testing in sleep laboratory before SARPE (T0), after SARPE (T1), and after removal of full fixed appliances (T2). Study models and anteroposterior cephalometric radiographs were also taken at the 3 time points. Results: Study model analysis showed significant relapse for intermolar and intercanine widths. Anteroposterior cephalometric results were significant only for effective maxillary width. There were no significant changes in any sleep stages, however a dramatic reduction in snoring as well as fewer stage shifts were observed. Conclusions: Although statistically significant relapse was observed on study models and anteroposterior cephalometric radiographs, the dental relapse appears to be more clinically significant than the skeletal relapse. SARPE appears to have a positive effect on sleep quality by reducing the snoring index as well as reducing transitions between sleep stages.

A expansão da maxila cirurgicamente assistida (EMCA) é um procedimento cirúrgico indicado para a correção da atresia maxilar em pacientes que já atingiram a maturação óssea. Os efeitos da EMCA são observados não só nos arcos dentários, maxilas e mandíbula, mas também na cavidade nasal, já que o septo nasal encontra-se localizado no centro do assoalho nasal, apoiado sobre a sutura palatina mediana. O objetivo deste estudo foi identificar a posição do septo nasal antes e após a separação cirúrgica das maxilas e avaliar sua influência na movimentação da maxila do lado que foi deslocado. Foram avaliadas 56 tomografias computadorizadas de feixe cônico (TCFC) adquiridas no tomográfo i-CAT Classic®, com voxel de 0,3mm, de 14 indivíduos submetidos à EMCA nos períodos préoperatório e pós-operatório de 15, 60 e 180 dias. Inicialmente, as imagens pósoperatórias foram visualizadas nas reformatações multiplanares, para identificar a qual maxila, direita ou esquerda, o septo nasal permaneceu ligado após a EMCA. Numa segunda etapa, foram realizadas medidas lineares nas imagens correspondentes aos períodos pré e pósoperatórios. Essas medidas foram realizadas na reformatação axial imediatamente acima do aparelho expansor, de forma padronizada para cada paciente, e consistiram da distância entre uma linha de referência central, que passava na espinha nasal anterior e no centro do forame incisivo, dividindo o paciente em lado direito e esquerdo, até os caninos e molares direitos e esquerdos. O índice kappa intraexaminador foi > 0,9. Para comparar as diferenças entre as médias dos dois grupos (lado ligado ao septo nasal e não ligado ao septo nasal) foi utilizado o teste t. Em 78,6% dos pacientes o septo nasal permaneceu ligado à maxila esquerda e em 21,4%, ligado à maxila direita. Em relação às medidas lineares, tanto na região de caninos como na região de molares, observouse que, no período pré-operatório, não havia diferença entre os lados direito e esquerdo. Após a EMCA, houve diferença estatisticamente significante (p<0,05), observando que houve menor movimentação da maxila a qual o septo nasal permaneceu ligado. Portanto, podese concluir que a expansão maxilar ocorre de forma assimétrica, pois a maxila que permanece ligada ao septo nasal, após a EMCA, movimenta-se menos do que a maxila não ligada ao septo nasal. / The Surgically assisted rapid palatal expansion (SARPE) is a surgical procedure indicated for the correction of maxillary constriction in adult patients. The effects of EMCA are observed not only in dental, maxillary, and mandibular arches, but also in the nasal cavity, since the septum is located in the center of the nasal floor and rests on the median palatine suture. The purpose of this study the position of the nasal septum before and after surgical separation of the maxillary, was to identify and evaluate their influence on the movement of the jaw which remained attached. Fifty six cone beam computed tomography (CBCT) scanner acquired i-CAT Classic, with 0.3 mm voxel. Fourteen individuals submitted to SARPE in the preoperative and postoperative periods of 15, 60, and 180 days which were evaluated. Initially, postoperative images were visualized using multiplanar reformatting to identify which jaw, right or left, the nasal septum remained bound after the SARPE. In a second step, linear measurements in the images corresponding to the pre- and postoperative periods were performed. These measurements were performed in the axial immediately above the expander reformatting, standardized form for each patient, and consisted of the distance from a central reference line, passing the anterior nasal spine and the center of the incisive foramen, dividing the patient\'s right side and left to the canines and molars on the right and left. The intraobserver kappa index was > 0.9. To compare the differences between the means of two groups (side connected to the nasal septum and not connected to the nasal septum) a t test was used. In 78.6% of patients, the nasal septum remained attached to the left maxilla and 21.4% on right jaw. Regarding linear measurements, both in the region of canines as in the molar region, it was observed that, in the preoperative period, there was no difference between the right and left sides. After the SARPE, a statistically significant difference (p < 0.05) was observed, noting that there was less movement of the maxilla which the nasal septum remained connected. Therefore, it can be concluded that the expansion jaw is asymmetrical because the jaw remains on the nasal septum after SARPE and moves less than maxilla not connected to the nasal septum.

Introduction: L’expansion palatine du maxillaire a beaucoup d’effets positifs sur la respiration et la qualité du sommeil, mais peu d'études ont examiné ces données sur des adultes ayant dépassé l’âge permettant de bénéficier d'une expansion palatine conventionnelle. Le but de cette recherche est d’évaluer la stabilité de l’EPRAC (expansion palatine rapide assistée chirurgicalement) et son effet sur les troubles respiratoires après l’ablation des appareils orthodontiques. Méthodes: Neuf patients (Âge moyen 21, entre 16-39 ans) nécessitant une EPRAC ont passé des nuits dans un laboratoire de sommeil, et ce avant l’EPRAC, après l’EPRAC, et après l’ablation des appareils fixes. Les radiographies céphalométriques postéroantérieures ainsi que les modèles d’étude ont été pris pendant ces trois périodes de temps. Résultats: L’analyse des modèles d’étude a démontré une récidive significative au niveau des distances inter-molaires et inter-canines au niveau du maxillaire seulement. Les analyses céphalométriques ont démontré une récidive au niveau de la largeur maxillaire. Aucun changement important n'a été observé dans les stades de sommeil, mais une réduction importante dans l’index de ronflement a été notée. De plus, il y avait moins de changements entre les stades de sommeil. Conclusions: La récidive squelettique est minime et cliniquement non significative. Par contre, les changements dans les distances intermolaires et intercanines sont cliniquement importants. Il semble également qu'une EPRAC ait un effet positif sur la qualité de sommeil par la réduction de l’indice de ronflement ainsi que sur la diminution des changements entre les stades de sommeil. / Introduction: Orthopedic expansion appears to have several positive effects on respiration as well as sleep quality, but a lack of studies examine these findings using SARPE on skeletally mature individuals. The aim of this study was to evaluate post-SARPE stability as well as its effect on sleep disordered breathing after completing full fixed orthodontics. Methods: 9 patients (average age 21, range 16-39) requiring SARPE underwent polysomnographic testing in sleep laboratory before SARPE (T0), after SARPE (T1), and after removal of full fixed appliances (T2). Study models and anteroposterior cephalometric radiographs were also taken at the 3 time points. Results: Study model analysis showed significant relapse for intermolar and intercanine widths. Anteroposterior cephalometric results were significant only for effective maxillary width. There were no significant changes in any sleep stages, however a dramatic reduction in snoring as well as fewer stage shifts were observed. Conclusions: Although statistically significant relapse was observed on study models and anteroposterior cephalometric radiographs, the dental relapse appears to be more clinically significant than the skeletal relapse. SARPE appears to have a positive effect on sleep quality by reducing the snoring index as well as reducing transitions between sleep stages.

Made available in DSpace on 2016-08-03T16:31:14Z (GMT). No. of bitstreams: 1 Ana Paula Morales.pdf: 1213456 bytes, checksum: 55c9a80ac27170e4b4a575007723155b (MD5) Previous issue date: 2009-03-31 / The purpose of this study was to evaluate horizontal and vertical smile characteristics; smile symmetry and smile arch of patients with maxillary atresy submitted to rapid palatal expansion. The sample was 81 extra oral photographs of maximum smile of 27 patients with medium age of 10 years. Photographs of maximum smile were taken at: inicial time or before expansion; 3 months after rapid palatal expansion ending and 6 months after rapid palatal expansion ending. The computer program CEFX 2001 Cefalometria Computadorizada CDT was used for photographies calibration and analysis. The reference points and measurements were chosen according to literature review about smile analysis. Statistical analysis was performed by using ANOVA variance analysis, at level of 5% of significance. Rapid palatal expansion resulted on estatistically significant increase of smile transversal area and upper central and lateral incisors display; maintenance of right and left side smile symmetry and absence of parallelism of curvature of the upper incisal edges and border of lower lip (smile arch).(AU) / O objetivo deste estudo foi avaliar as possíveis alterações das características horizontais, verticais, de simetria e do arco do sorriso de pacientes com atresia maxilar submetidos à expansão rápida da maxila. A amostra consistiu de 81 fotografias extra-bucais do sorriso máximo de 27 pacientes com idade média de 10 anos e 3 meses. Foram realizadas fotografias do sorriso máximo nos períodos: inicial (antes da instalação do aparelho expansor); 3 meses após a fixação do parafuso expansor; 6 meses após a fixação do parafuso expansor. Para a calibragem e análise das fotografias foi utilizado o programa CEFX 2001 CDT. Os pontos fotométricos e as medidas a serem analisadas foram escolhidos após revisão da literatura do sorriso realizada. Para avaliar as alterações no sorriso durante as fases, foi utilizada a análise de variância ANOVA, com nível de significância de 5%. A expansão rápida da maxila promoveu aumento estatisticamente significante da dimensão transversal do sorriso; aumento da quantidade de exposição dos incisivos centrais e laterais superiores; manutenção da simetria entre os lados direito e esquerdo e da falta de paralelismo entre a curvatura das bordas dos incisivos superiores com a curvatura do lábio inferior (arco do sorriso).(AU)

A expansão da maxila cirurgicamente assistida (EMCA) é um procedimento cirúrgico indicado para a correção da atresia maxilar em pacientes que já atingiram a maturação óssea. Os efeitos da EMCA são observados não só nos arcos dentários, maxilas e mandíbula, mas também na cavidade nasal, já que o septo nasal encontra-se localizado no centro do assoalho nasal, apoiado sobre a sutura palatina mediana. O objetivo deste estudo foi identificar a posição do septo nasal antes e após a separação cirúrgica das maxilas e avaliar sua influência na movimentação da maxila do lado que foi deslocado. Foram avaliadas 56 tomografias computadorizadas de feixe cônico (TCFC) adquiridas no tomográfo i-CAT Classic®, com voxel de 0,3mm, de 14 indivíduos submetidos à EMCA nos períodos préoperatório e pós-operatório de 15, 60 e 180 dias. Inicialmente, as imagens pósoperatórias foram visualizadas nas reformatações multiplanares, para identificar a qual maxila, direita ou esquerda, o septo nasal permaneceu ligado após a EMCA. Numa segunda etapa, foram realizadas medidas lineares nas imagens correspondentes aos períodos pré e pósoperatórios. Essas medidas foram realizadas na reformatação axial imediatamente acima do aparelho expansor, de forma padronizada para cada paciente, e consistiram da distância entre uma linha de referência central, que passava na espinha nasal anterior e no centro do forame incisivo, dividindo o paciente em lado direito e esquerdo, até os caninos e molares direitos e esquerdos. O índice kappa intraexaminador foi > 0,9. Para comparar as diferenças entre as médias dos dois grupos (lado ligado ao septo nasal e não ligado ao septo nasal) foi utilizado o teste t. Em 78,6% dos pacientes o septo nasal permaneceu ligado à maxila esquerda e em 21,4%, ligado à maxila direita. Em relação às medidas lineares, tanto na região de caninos como na região de molares, observouse que, no período pré-operatório, não havia diferença entre os lados direito e esquerdo. Após a EMCA, houve diferença estatisticamente significante (p<0,05), observando que houve menor movimentação da maxila a qual o septo nasal permaneceu ligado. Portanto, podese concluir que a expansão maxilar ocorre de forma assimétrica, pois a maxila que permanece ligada ao septo nasal, após a EMCA, movimenta-se menos do que a maxila não ligada ao septo nasal. / The Surgically assisted rapid palatal expansion (SARPE) is a surgical procedure indicated for the correction of maxillary constriction in adult patients. The effects of EMCA are observed not only in dental, maxillary, and mandibular arches, but also in the nasal cavity, since the septum is located in the center of the nasal floor and rests on the median palatine suture. The purpose of this study the position of the nasal septum before and after surgical separation of the maxillary, was to identify and evaluate their influence on the movement of the jaw which remained attached. Fifty six cone beam computed tomography (CBCT) scanner acquired i-CAT Classic, with 0.3 mm voxel. Fourteen individuals submitted to SARPE in the preoperative and postoperative periods of 15, 60, and 180 days which were evaluated. Initially, postoperative images were visualized using multiplanar reformatting to identify which jaw, right or left, the nasal septum remained bound after the SARPE. In a second step, linear measurements in the images corresponding to the pre- and postoperative periods were performed. These measurements were performed in the axial immediately above the expander reformatting, standardized form for each patient, and consisted of the distance from a central reference line, passing the anterior nasal spine and the center of the incisive foramen, dividing the patient\'s right side and left to the canines and molars on the right and left. The intraobserver kappa index was > 0.9. To compare the differences between the means of two groups (side connected to the nasal septum and not connected to the nasal septum) a t test was used. In 78.6% of patients, the nasal septum remained attached to the left maxilla and 21.4% on right jaw. Regarding linear measurements, both in the region of canines as in the molar region, it was observed that, in the preoperative period, there was no difference between the right and left sides. After the SARPE, a statistically significant difference (p < 0.05) was observed, noting that there was less movement of the maxilla which the nasal septum remained connected. Therefore, it can be concluded that the expansion jaw is asymmetrical because the jaw remains on the nasal septum after SARPE and moves less than maxilla not connected to the nasal septum.