SARME stands for Surgically Assisted Rapid Maxillary Expansion. Its primary use is to widen a small or narrow upper jaw. Widening the upper jaw creates sufficient room for complete dental alignment without needing to remove teeth.
It's highly effective in widening the nasal airway and stretching out the soft palate to help prevent upper airway collapse when sleeping. SARME broadens the upper dental arch which creates a broader, more aesthetically pleasing smile.
It's important to note that a standalone SARME doesn't widen the upper jaw in a symmetrical or level manner. As small jaws are three dimensionally small, simple widening will not increase the height or forward projection of the upper jaw.
A secondary LeFort surgery, usually as part of a comprehensive BiMax procedure, is often required to bring the upper jaw forward and accurately position it symmetrically and in proportion with the rest of the face.
Expansion of the upper jaw is commonly used to relieve dental crowding in teenage patients with a simple expander fixed to the teeth. Once the facial bones have stopped growing at around 16-18 years of age, widening the upper jaw becomes more complex.
Expansion of the upper arch is achieved by widening the palatal growth suture in the middle of the roof of the mouth. A simple orthodontic expander is highly effective in children and teenagers to open the suture and widen the upper jaw.
At about 16-18 years of age the palatal suture is almost fused and not easily opened. Using a simple orthodontic expander when the suture has fused may have the catastrophic effect of pushing teeth out of jaw bone without widening the jaw.
In patients where the patalal suture is only partially fused, a MARME (Mini-Implant Assisted Maxillary Expansion) device can be used. This can be more advantageous because the device is secured to bone rather than teeth, so any expansion tends to be skeletal.
If the suture is fully fused then a MARME is unlikely to be successful. The outcome using a MSE isn't guaranteed, but may be a good option in the 18-25 year olds. It's more conservative than a SARME and can be done under local anaesthetic.