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Oral Surgery/Sarpe surgery!


Hello Doctor Teig

I just have two simple questions for you.
I wrote to you some months ago, telling about a problem I had in the results of a Sarpe.
After two years after the surgery I still  have the malocclusion (crossbite) on the left side, as the surgeon did not cut the bones enough and did not even reopen the wounds and look for some incomplete cuts. I do not know how to classify the attitudes of the surgeon, but the consequence is that he forced me to another surgery, which I am considering to have in a short future, even though you answered to my first question that there are some risks involving a new surgery, to cut bones that have already been cut.
These are my questions for you in this regard:

3 Is it necessary to cut the mid-palatal suture even in a unilateral surgery like now I need, or cut only the upper maxilla on the left side is enough?

4 How long do I have to keep the hyrax in my mouth in order to have a complete bone consolidation?

Thank you for your help
My best regards

Savio - I cannot be completely sure without examining you, but if you only had an expansion of one side, most likely the mid-palatal suture was not completely cut.  For that reason and to better control the pace of expansion and the extent of expansion, it is better to cut the mid-palatal suture to insure a proper expansion.

Once the proper expansion has occurred in a few weeks, the doctor needs to fuse the appliance at that position. The expander needs to be in place without any movement for a minimum of 6 months and often a longer period of time to insure complete bone consolidation.

If you have additional questions, feel free to contact me again.  

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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