SARPE/DOME

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What is SARPE/DOME?

SARPE(Surgically Assisted Rapid Palatal Expansion) and DOME(Distraction Osteogenesis for Maxillary Expansion) are both surgical operations that separate the upper jaw from the rest of your facial structure and split it along your sagittal plane, slowly expanding your upper jaw horizontally. They do it with different cuts for different reasons.

Both involve a Le Fort I Osteotomy to frees the maxilla (upper jaw) from the rest of the facial skeleton and a Vertical Midline Osteotomy to split the maxilla(specifically cut the mid-palatal suture) into right and left halves. Both have an expander on your upper jaw to hold the two halves together during recovery and jaw expansion.

However, for why people get these surgeries done, SARPE is for orthodontic purposes, e.g., dental arch correction, while DOME is for airway purposes, e.g., high-arched palate, nasal obstruction, or Obstructive Sleep Apnea(OSA) wanting airway improvement.

The main surgical difference is that the expander is attached to the teeth(tooth-borne) for SARPE, but attached to the bone(bone-borne) for DOME. Pterygoid disjunction is sometimes done in SARPE, but not DOME.

Le Fort 1 Osteotomy

What to Expect: SARPE

SARPE(Surgically Assisted Rapid Palatal Expansion) is a major surgical operation for orthodontic purposes, e.g., dental arch correction, that takes place in the hospital, with planning from your orthodontist and oral surgeon.

You will have a consult and CBCT scan to determine your tentative treatment plan after reviewing the orthodontist's recommendations.
An teeth-borne expander will anchor the left and right parts of your upper jaw by your teeth.
The surgery will take place either in office or in the hospital, depending on the severity of the case, but you will be fully under anesthesia.
The surgery will occur inside your mouth, preventing facial scarring, where the surgeon will make cuts in your upper jaw.
Le Fort I Osteonomy separates your upper jaw from the rest of your face structure.
Vertical Midline Osteotomy splits the maxilla(specifically cut the mid-palatal suture) into right and left halves.
1. A Pterygoid Disjunction may be done after or during the Vertical Midline Osteotomy to separate the maxilla and the pterygoid plates of the sphenoid for a more complete release.
Follow your instructed recovery plan for 1-3 weeks. In general, you will have to keep your mouth clean, not overstrain your jaw, not smoke, have a liquid diet that eases into a soft diet, and take pain, antibiotic, and inflammation medications.
After 3-5 days of recovery, use a special key to turn the expander 1-2 times everyday to slowly expand your jaw for 2-4 weeks.
Afterwards, keep the device on without turning for 3-6 weeks to allow for bone remineralization.
The expander will be removed in a smaller procedure that will take place in office.

What to Expect: DOME

DOME(Distraction Osteogenesis for Maxillary Expansion) is a major surgical operation, for airway purposes, e.g., high-arched palate, nasal obstruction, or OSA, that takes place in the hospital, with planning from your orthodontist and oral surgeon.

You will have a consult and CBCT scan to determine your tentative treatment plan after reviewing the orthodontist's recommendations.
An bone-borne expander will anchor the left and right parts of your upper jaw directly.
The surgery will take place either in office or in the hospital, depending on the severity of the case, but you will be fully under anesthesia.
The surgery will occur inside your mouth, preventing facial scarring, where the surgeon will make cuts in your upper jaw.
Le Fort I Osteonomy separates your upper jaw from the rest of your face structure.
Vertical Midline Osteotomy splits the maxilla(specifically cut the mid-palatal suture) into right and left halves.
Follow your instructed recovery plan for 1-3 weeks. In general, you will have to keep your mouth clean, not overstrain your jaw, not smoke, have a liquid diet that eases into a soft diet, and take pain, antibiotic, and inflammation medications.
After 3-7 days of recovery, use a special key to turn the expander 1-2 times everyday to slowly expand your jaw for 2-3 weeks.
Afterwards, keep the device on without turning for 3-6 weeks to allow for bone remineralization.
The expander will be removed in a smaller procedure that will take place in office.