Periodontal side effects of rapid and slow maxillary expansion: A systematic review

Abstract

Objectives: To identify the scientific evidence that demonstrates which of the transverse maxillary treatments has the least effect on periodontal tissues. Materials and Methods: PubMed (MEDLINE), Cochrane Library, Scopus, Web of Science, Virtual Health Library, Google Scholar, and OpenGrey were searched without restrictions. A hand search was also carried out in the reference lists of the articles selected. The related articles tool in the PubMed database was checked for each article included. Risk of bias assessment was performed using Cochrane Collaboration's Risk of Bias tool for randomized clinical trials and the ROBINS-I tool for nonrandomized studies of interventions. The GRADE tool was used to assess the quality of the evidence. Results: After examination of the full texts, three studies were finally included. Two studies used a Haas expander with different protocols, and one study used a Haas expander compared with a quad-helix appliance. These studies evaluated periodontal parameters and periodontal indices by clinical examination with a millimeter probe, and one study examined computed tomography images. After quality assessment, two studies were considered as having a “low” risk of bias. One study was scored as having a moderate risk of bias. The evidence was graded as moderate quality for alveolar bone level, tooth displacement, and inclination and very low for all other outcomes. Conclusions: There were no significant differences to enable a sound conclusion about which type of maxillary expansion has the least periodontal side effects.

Mini Hyrax vs Hyrax expanders in the rapid palatal expansion in adolescents with posterior crossbite: a randomized controlled clinical trial

“…The wearing of both expanders increased the transverse distances of premolars and molars, varying from 5.93 to 6.55 mm, similar to what has been reported elsewhere [22][23][24][25]. The tooth rotation varied from − 1.05 o to 1.77 o , without a specific direction for each type of expander and without a statistically significant difference between them, as reported in another study [27], in which tooth rotation was minimal and did not provoke any relevant clinical drawbacks.…”

“…According to systematic reviews published in recent years, scientific evidence on RPE is basically limited to the assessment of the effects of orthodontic expanders on hard and soft tissues of the stomatognathic system [22][23][24][25]. Researchers have not fully explored the impact of these interventions on the quality of life of individuals [11,14].…”

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

“…Nevertheless, relative to which device would be less harmful to periodontal tissues, a current systematic review concluded that there were no significant differences between the two expanders and considered the devices equally safe for oral health. 19 The proposed approach was firstly based on the gold standard protocol 9,10 by means of antibiotic therapy (amoxicillin) since the open ulcers served as a microbial reservoir, with the possibility of blood contamination. Moreover, the symptomatology presented by the patient (fever state, painful, prostration and very unwell condition) showed the clear signs of disseminated infection, making prescription mandatory in such cases.…”

Pulp changes from rapid maxillary expansion: A systematic review

“…For example, dental anchorage may cause buccal tipping, root resorption or extrusion of the anchor teeth, compression of the periodontal ligament, buccal bone resorption and bending of the alveolar bone during the distraction phase 3 . A systematic review evaluated periodontal side effects of rapid and slow maxillary expansion, and there were no significant differences which type of maxillary expansion has the least periodontal side effects 4 . Regarding the dental pulp, the expected changes include microcirculatory changes, pulpal blood flow interruption, haemorrhage, pulp calcifications 5,6 and odontoblastic degeneration and vacuolization of pulp tissues 7 .…”