This procedure is primarily done in adult patients whose maxillary sutures are fused and cannot be expanded via other techniques.
For the first surgery, under local anaesthesia and iv sedation or general anesthesia, a patient first goes through Le Fort fracture of skull without the downfracture of maxilla.
Sangsari et al. published a systematic review and a meta-analysis in 2016 which studied the effects of PMD on the outcome of SARPE.
From the three studies that were included in their criteria, they concluded that the literature is inconclusive regarding the effect of PMD on the outcomes of SARPE and that further controlled trials are needed.
[4] Chamberland and Profitt in 2011 published a paper in AJODO which looked at long-term and short-term effects of SARPE procedure.