Surgically Assisted Rapid Palatal Expansion

The roof of the mouth is also called the palate. When the palate is too narrow, issues with the bite, the alignment of the teeth, or breathing can result. An orthodontic device called a palatal expander is a common device used to widen the palate during orthodontic treatment for children and young teens with dental crowding, misaligned teeth, crossbites, and other issues. However, around puberty, the bones in the palate fuse into what is called the midline suture, leading to the need for more complex treatment for older teens and adults with narrow palates. Such treatment may require a combination of both surgical and orthodontic processes to re-open the fused suture and widen the palate — a cooperative treatment known as SARPE (Surgically Assisted Rapid Palatal Expansion).

Dr. Esmail is highly skilled and trained in this surgical technique and will work closely with your orthodontist to complete treatment. Before surgery, your orthodontist will provide a custom-made palatal expander that will be cemented to the first molars and premolars. The patient will activate this device post-surgery with a special key that turns a screw within the expander, applying pressure to the right and left sides of the upper jaw to expand it slowly and gently over a few months’ time. During surgery, the patient will be sedated, and their upper jaw will be surgically cut in specific locations to separate the upper jaw into bone segments that can be moved into the desired positions once the expander is activated. Over the next few months, the patient will activate the expander each day until the desired width is achieved. The two front teeth will often show a separation, indicating to the doctors that expansion is occurring. After the desired expansion is achieved, the expander will remain in place for several months to allow the jaw bone to heal. Once healing is complete, and the expander is removed, orthodontic treatment to close the space between the two front teeth and move the other teeth into proper alignment will begin.