Stability and surgical complications of tooth-borne and bone-borne appliances in surgical assisted rapid maxillary expansion: a systematic review

Muñoz-Pereira, M.E.; Haas, Orion Luiz; Meirelles, Lucas da Silva; Machado-Fernández, A.; Guijarro‐Martínez, Raquel; Hernández–Alfaro, Federico; Oliveira, Rogério Belle de; Pagnoncelli, Rogério Miranda

doi:10.1016/j.bjoms.2020.08.017

Cited by 12 publications

(6 citation statements)

References 68 publications

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“…In practice, devices fixed onto teeth, directly to the bone or hybrid fixation appliances are used. Each type of expander has its supporters and opponents [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

et al. 2021

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The aim of this study was to compare the reduced stresses according to Huber’s hypothesis and the displacement pattern in the region of the facial skeleton using a tooth- or bone-borne appliance in surgically assisted rapid maxillary expansion (SARME). In the current literature, the lack of updated reports about biomechanical effects in bone-borne appliances used in SARME is noticeable. Finite element analysis (FEA) was used for this study. Six facial skeleton models were created, five with various variants of osteotomy and one without osteotomy. Two different appliances for maxillary expansion were used for each model. The three-dimensional (3D) model of the facial skeleton was created on the basis of spiral computed tomography (CT) scans of a 32-year-old patient with maxillary constriction. The finite element model was built using ANSYS 15.0 software, in which the computations were carried out. Stress distributions and displacement values along the 3D axes were found for each osteotomy variant with the expansion of the tooth- and the bone-borne devices at a level of 0.5 mm. The investigation showed that in the case of a full osteotomy of the maxilla, as described by Bell and Epker in 1976, the method of fixing the appliance for maxillary expansion had no impact on the distribution of the reduced stresses according to Huber’s hypothesis in the facial skeleton. In the case of the bone-borne appliance, the load on the teeth, which may lead to periodontal and orthodontic complications, was eliminated. In the case of a full osteotomy of the maxilla, displacements in the buccolingual direction for all the variables of the bone-borne appliance were slightly bigger than for the tooth-borne appliance.

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“…In practice, devices fixed onto teeth, directly to the bone or hybrid fixation appliances are used. Each type of expander has its supporters and opponents [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

et al. 2021

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“…The current study employed the same risk of bias scale utilized in a prior systematic review [13] investigating the complications of SARPE to evaluate the strength of evidence presented in each of the studies included in the analysis. The evaluation criteria comprised a range of factors that are listed in Table 2.…”

Section: Risk Of Bias/quality Assessmentmentioning

confidence: 99%

“…Ultimately, after undergoing a comprehensive assessment based on the predetermined inclusion criteria, a total of 7 articles were deemed eligible and subsequently included in the final analysis [9,11,[14][15][16][17][18]. The other 19 articles were excluded due to the following reasons: nine lacked maxillary cephalometric measurements [8,13,[20][21][22][23][24][25][26]; three were focused on nonsurgical RPE [27][28][29]; three included patients with orthodontic tooth movement between the two time points of obtaining radiological images [10,30,31]; two were systematic reviews [32,33]; one was reported again in a later study by the same team [34]; and one was a case series with limited sample size [35]. The PRISMA flowchart of the article inclusion and exclusion screening is shown in Figure 1.…”

Section: Literature Searching and Study Selectionsmentioning

confidence: 99%

Sagittal and Vertical Changes of the Maxilla after Surgically Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis

Lin,

Wang,

Abdullah

et al. 2023

JCM

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Surgically assisted rapid palatal expansion (SARPE) is often performed to correct the transverse deficiency in the maxilla for skeletally mature patients. However, there is little consensus on the sagittal and vertical displacement of the maxilla after SARPE. This systematic review aims to analyze the position changes of the maxilla in the sagittal and vertical dimensions after the completion of SARPE. Registered with PROSPERO (registration number: CRD42022312103), this study complied with the 2020 PRISMA guideline and was conducted on 21 January 2023. Original studies were screened from MEDLINE (PubMed), Elsevier (SCOPUS), and Cochrane, and supplemented by hand-searching. Cephalometric changes of skeletal vertical and sagittal measurements were the focus. A fixed-effects model was applied in R for meta-analysis. After applying inclusion and exclusion criteria, seven articles were included in the final review. Four studies had a high risk of bias, and the other three had a medium risk of bias. Meta-analysis revealed that the SNA angle increased by 0.50° ± 0.08° (95% confidence interval, 0.33° to 0.66°), and the SN–PP angle increased by 0.60° ± 0.09° (95% confidence interval, 0.41° to 0.79°) after SARPE. In summary, the maxilla displayed statistically significant forward and clockwise downward movement after SARPE. However, the amounts were small and might not be clinically significant. Due to the high risk of bias of included studies, our results must be taken cautiously. Future studies are needed to discern the effects of direction and angulation of the osteotomies of SARPE on the displacement of the maxilla.

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“…Previous systematic reviews investigated some complications after orthopaedic (ORME) or surgically assisted rapid maxillary expansion (SARME) (eg epistaxis, 17 teeth mobility or discoloration, 3,17,18 pain, 3,17,18 asymmetric or inadequate expansion, 3,17 gingival recession 18 and bone or root resorption 18‐20 ); however, there is no systematic review that summarized the existing evidence focussed on possible effects of RME on dental pulp.…”

Section: Introductionmentioning

confidence: 99%

“…Although a recent systematic review has shown that orthodontic treatment cannot cause pulp necrosis, 16 only one eligible study of this previous review investigated the effects of RME on the dental pulp. 10 Previous systematic reviews investigated some complications after orthopaedic (ORME) or surgically assisted rapid maxillary expansion (SARME) (eg epistaxis, 17 teeth mobility or discoloration, 3,17,18 pain, 3,17,18 asymmetric or inadequate expansion, 3,17 gingival recession 18 and bone or root resorption [18][19][20] ); however, there is no systematic review that summarized the existing evidence focussed on possible effects of RME on dental pulp.…”

mentioning

confidence: 99%

Pulp changes from rapid maxillary expansion: A systematic review

Vieira

Oliveira

Machado

et al. 2021

Orthod Craniofacial Res

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The dental pulp is a specialized tissue formed by connective tissue surrounded by mineralized dental tissues. 1 Its vitality and sensibility are established by the presence of the vascular-nervous bundle, which nourishes the pulp through the apical foramen. 2 When exposed to an aggressor agent, the pulp can present inflammatory or degenerative reactions that depend on the type, frequency and intensity of the irritating stimulus. 1 Local factors such as mechanical stimuli produced by orthodontic movement can stimulate a series of morphological and functional changes in the oral cavity. For example, dental anchorage may cause

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Stability and surgical complications of tooth-borne and bone-borne appliances in surgical assisted rapid maxillary expansion: a systematic review

Cited by 12 publications

References 68 publications

Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

Sagittal and Vertical Changes of the Maxilla after Surgically Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis

Pulp changes from rapid maxillary expansion: A systematic review

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