Effects of surgically assisted rapid maxillary expansion on the anterior maxillary teeth and trabecular bone structure: a controlled clinical study.

OBJECTIVES: To assess the effects of surgically assisted rapid maxillary expansion (SARME) on the color of maxillary anterior teeth, to evaluate the associations between tooth color changes, pulp sensibility, trabecular bone structure of the midpalatal suture and suture-adjacent alveolar bone and to compare these findings with a non-expanded control group. MATERIALS AND METHODS: Fifteen patients undergoing SARME (22.07 ± 3.37 years) and 15 untreated controls (23.87 ± 1.13 years) were included. In the SARME group at baseline (T0), immediately after expansion (T1), at 3 (T2) and 6 months (T3), tooth color of the maxillary anterior teeth was measured with a spectrophotometer to obtain CIE L*, a*, b* (L*: lightness; a*: red-green axis; b*: yellow-blue axis) values and calculate ΔE₀₀ (Color changes), and pulp sensibility was assessed with an electric pulp tester (EPT). In the control group, these assessments were conducted at baseline (T0), 1 month (T1), 3 months (T2), and 6 months (T3). In the SARME group, baseline and 6-month cone-beam computed tomography images (CBCT) were analyzed using fractal analysis (FA) to evaluate the trabecular structure of the midpalatal suture and adjacent alveolar bone. RESULTS: In the SARME group, L* values increased significantly at 3-months and showed no change from 3 to 6 months. ΔE₀₀ values were significantly higher than control group at 6 months. Negative pulp sensibility responses increased immediately after expansion and decreased by 6 months. Fractal dimension values decreased at both sites, but only the suture-adjacent alveolar bone showed moderate correlations with ΔL* and ΔE00 of the maxillary incisors. CONCLUSIONS: Within the 6-month follow-up, SARME induced color differences in the maxillary anterior teeth that remained clinically acceptable. Pulp sensibility improved toward baseline levels by 6-months. FD values demonstrated a significant decrease during the observation period. CLINICAL RELEVANCE: SARME may cause clinically acceptable color changes and temporary alterations in pulp sensibility. These findings should be considered during treatment planning and patient information.