Expansion of maxillary arches with crossbite: a systematic review of RCTs in the last 12 years

Abstract

The aim of this study was to review recent randomized clinical trials (RCTs) dealing with the effectiveness of various modalities of orthopaedic/orthodontic expansion of maxillary arches with crossbite and the associated 6 month post retention stability. The study selection criteria included RCTs involving subjects with maxillary deficiency with crossbite, with no limits of age. The authors searched the following electronic databases from 1999 to January 2011: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, LILACS, and WEB of SCIENCE. The search strategy resulted in 12 articles meeting the inclusion criteria. Most of the studies did not meet major methodological requirements; some studies were not relevant because of small sample size, possible bias and unaccounted for confounding variables, lack of blinding in measurements, and deficient statistical methods. Treatment outcomes were different depending on the appliance used, tooth tissue-borne/tooth-borne expanders, bonded semi-rapid maxillary expansion (SRME), or rapid maxillary expansion (RME); in any case, methodological flaws prevent any sound conclusion. Stable results have been measured at the 6 month follow-up after removal of the retention plate in the treated groups in the maxillary intermolar and intercanine distances. Long-term stability results should be assessed. The Consolidated Standards of Reporting Trials (CONSORT) Statement could be helpful in improving the reporting of RCTs.

Dental and skeletal effects of palatal expansion techniques: a systematic review of the current evidence from systematic reviews and meta‐analyses

“…The 12 SRs/MAs included and the data extracted are reported in Table . Four SRs were integrated with MA .…”

“…Dentoalveolar transversal effects of RME : Maxillary intermolar width. During the retention phase, approximately 85% of the initial expansion amount was maintained after RME with the Hyrax ( low evidence) . Residual expansion after the retention phase was reported with the QH ( low evidence), and with the Hyrax or the Haas or the Haas in association with a fixed edgewise orthodontic appliance ( very low to moderate evidence). Maxillary intercanine width. A residual expansion after the retention phase was reported with the QH ( low evidence), the Haas or Hyrax ( very low to moderate evidence), and the Haas expander in association with a fixed edgewise orthodontic appliances ( low evidence).…”

“…Residual expansion after the retention phase was reported with the QH ( low evidence), and with the Hyrax or the Haas or the Haas in association with a fixed edgewise orthodontic appliance ( very low to moderate evidence). Maxillary intercanine width. A residual expansion after the retention phase was reported with the QH ( low evidence), the Haas or Hyrax ( very low to moderate evidence), and the Haas expander in association with a fixed edgewise orthodontic appliances ( low evidence). Maxillary interpremolar width. A residual expansion with the Hyrax or Haas ( moderate evidence) and the Haas expander in association with a fixed edgewise orthodontic appliances ( low evidence) was revealed.…”

“…The 12 SRs/MAs included and the data extracted are reported in Table 3 (10,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Four SRs were integrated with MA (21,25,28,31).…”

Evaluation of Cervical Posture Following Rapid Maxillary Expansion: A Review of Literature

“…There is also in the recent literature, an important case report in which the authors try to hypothesized that the changes in the palatal width obtained with RME appliances can involve other bone structures such as the tongue’s muscles and the suboccipital muscles. These structures are functionally bound and cooperate to manage the head and neck position, [18-23]. Solow et al [19] and, Solow and Greve [20] observed a significant relationship between nasal airway adequacy and changes in posture head.…”