Comparison of rapid versus slow maxillary expansion on patient-reported outcome measures in growing patients: a systematic review and meta-analysis

Rutili, Valentina; Nieri, Michele; Franceschi, Debora; Pierleoni, Felicita; Giuntini, Veronica; Franchi, Lorenzo

doi:10.1186/s40510-022-00440-5

Cited by 15 publications

(8 citation statements)

References 58 publications

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“…The occurrence of skeletal expansion was clinically assumed by the appearance of the diastema between central incisors. In this regard, slow maxillary expansion generates similar dento-skeletal effect compared to RME, with less stress exerted on the midpalatal suture and less discomfort in children [ 23 , 24 ]. However, since the study did not include radiographic examination of post-treatment changes, it was not possible to quantitative estimate either the amount of skeletal expansion on both sides or the ratio between skeletal and dento-alveolar effects.…”

Section: Discussionmentioning

confidence: 99%

Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis

Ronsivalle,

Isola,

Lo Re

et al. 2023

Prog Orthod.

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Background Previous evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12–18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments. Results At T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05). Limitations The small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials. Conclusions Subjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion.

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Section: Discussionmentioning

confidence: 99%

Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis

Ronsivalle,

Isola,

Lo Re

et al. 2023

Prog Orthod.

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“…Note that a 2% w/v MC solution (moderately thick, Level 3) was also tested, but negligible aspiration was observed and thus not presented. To evaluate the swallowing effort, the liquid was dispensed at two different speeds, namely normal and slow, which involved dispensing 5 mL of liquid within 1 s and 3 s, respectively [38][39][40]. Each test was repeated at least three times to ensure consistency.…”

Section: Methodsmentioning

confidence: 99%

Liquid Dynamics in the Upper Respiratory–Digestive System with Contracting Pharynx Motions and Varying Epiglottis Angles

Seifelnasr,

Si,

Ding

et al. 2024

Liquids

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Swallowing disorders, or dysphagia, can lead to bolus aspiration in the airway, causing serious adverse health effects. Current clinical interventions for dysphagia are mainly empirical and often based on symptoms rather than etiology, of which a thorough understanding is still lacking. However, it is challenging to study the swallowing process that involves sequential structural motions and is inaccessible to standard visualization instruments. This study proposed an in vitro method to visualize swallowing hydrodynamics and identify the fundamental mechanisms underlying overflow aspirations. An anatomically accurate pharynx–epiglottis model was developed from patient-specific CT images of 623 µm isotropic resolution. A compliant half-pharynx cast was prepared to incorporate dynamic structures and visualize the flow dynamics in the mid-sagittal plane. Three locations of frequent overflow aspiration were identified: the epiglottis base, cuneiform tubular recesses, and the interarytenoid notch. Water had a consistently higher aspiration risk than a 1% w/v methylcellulose (MC) solution. The contracting–relaxing pharynx and flapping epiglottis spread the liquid film, causing a delayed esophageal entry and increased vallecular residual, which was more pronounced with the MC solution. Dispensing the liquid too slowly resulted in water aspiration, whereas this was not observed with the MC solution. An incomplete epiglottis inversion, such as horizontal or down-tilt 45°, aggravated the aspiration risks of water. This study suggests that it is practical to use anatomically accurate respiratory–digestive models to study the swallowing process by incorporating varying physiological details.

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“…There are no differences in discomfort between the two treatments in the weeks that followed. [ 32 ] Speaking, swallowing, hypersalivation, hygiene, and patient and parent satisfaction scores did not significantly differ between the RME and SME. Neither the significant differences found in hypersalivation, hygiene, or patient or parent satisfaction scores.…”

Section: Introductionmentioning

confidence: 98%

Unusual systemic and nondental effects of maxillary expansion therapy: A comprehensive and updated review of literature

Khan,

Sharma,

Jindal

2023

Journal of Orthodontic Science

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In dental practice, pediatric patients with a wide range of manifestations of malocclusion viz. crossbite, dental crowding, and skeletal Class III due to transverse discrepancy of the abnormally constricted maxilla or palate are found. However, the dental management of such kind of malocclusion with narrow palate needs a meticulous dental evaluation. Appliances used for treating such malocclusion conditions may include Slow-Maxillary Expansion (SME) or Rapid Maxillary Expansion (RME) orthodontic or orthopedic appliances. Considerable success has been described in the literature using the maxillary/palatal expansion modality. Unusual systemic and nondental effects of expansion appliances therapy have been described in some scientific studies. However, no comprehensive review article has been published describing the nondental and systemic effects of RME/SME therapy in Pediatric Dentistry. Considering the above scenarios, the updated and comprehensive review of the relevant literature is necessary for health professionals. Dental professionals including pediatric dentists and orthodontists need to consider such untoward or unexpected effects of RME/SME treatment modality. Hence, the current comprehensive review article has been written with the aim to meticulously describe the relevant scientific literature about nondental/extraoral and systemic effects of RME/SME appliances.

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Comparison of rapid versus slow maxillary expansion on patient-reported outcome measures in growing patients: a systematic review and meta-analysis

Cited by 15 publications

References 58 publications

Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis

Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis

Liquid Dynamics in the Upper Respiratory–Digestive System with Contracting Pharynx Motions and Varying Epiglottis Angles

Unusual systemic and nondental effects of maxillary expansion therapy: A comprehensive and updated review of literature

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