Metal Mouth Message Board

Can treat difficult cases as narrow mandible?

Well, traditionally SARPE treats a narrow maxilla. I have heard of mandibular expansion but it seems far less common.

Is this surgery considered difficult?

I don't know...maybe sirwired or djspeece will pop in and have an answer. In my year plus on this board, I have only seen mandibular expansion mentioned on the rare occasion.

I understand it to be a pretty unstable procedure, especially if you're getting any work done on the maxilla as well. If it's just the mandible, you can probably find a doctor willing to do it. Getting that done in conjunction with complex maxillary work crosses the line of unacceptable instability according to some sources I've seen. Of course, "unacceptable" is up to the performing surgeon I have no doubt you could find a surgeon willing to do it in Asia or South America Perhaps also in Texas or CA, as the surgeons there are less liable (in terms of damages awarded) in cases of malpractice should things go south. Also, your chances of a TMJ issue arising from the jaw surgery probably go up. I'm not a doctor, but messing with the mandibular width seems to have someone unpredictable results on the TMJ, including possibly causing issues (such as chronic pain, jaw locking, etc.) that did not exist before the surgery.

Has an orthodontist evaluated you yet to determine you need the mandible widened? Narrow palates are common because of the interaction between palatal width and mouth-breathing as a child. Narrow mandibles are much more rare because that is mostly genetic. (It's certainly possible to have a narrow mandible, it's just much less common.)

But to answer your original question: No; the "P" in SARPE stands for "Palatal". The mandible has no easily-cut anatomical feature similar to the palatal suture (which is what is cut during a SARPE.)