scholarly journals Transverse Skeletal Effects of Rapid Maxillary Expansion in Pre and Post Pubertal Subjects: A Systematic Review

2019 ◽  
Vol 7 (3) ◽  
pp. 467-477 ◽  
Author(s):  
Nouran Fouad Seif-Eldin ◽  
Sherif Aly Elkordy ◽  
Mona Salah Fayed ◽  
Amr Ragab Elbeialy ◽  
Faten Hussein Eid

OBJECTIVE: The aim of this systematic review was to assess the transverse skeletal effects of rapid maxillary expansion (RME) in pre and post-pubertal subjects. MATERIAL AND METHODS: Five databases were searched till May 2018; Pubmed, Cochrane, Scopus, Lilacs and Web of science in addition to the manual search of other sources. There were no language restrictions. Methodological Index for Non-Randomized Studies MINORS was used to assess the quality and risk of bias of the trials included. RESULTS: Six studies were finally included in the qualitative analysis. A meta-analysis wasn’t performed due to the heterogeneity of methodologies and outcomes. All of the included studies showed drawbacks in their structure yielding weak evidence. On the short term, RME caused an increase in the maxillary and lateral-nasal widths in pre-pubertal subjects by 3.4 mm and 3.3 mm, and by 2.8 and 2.2 mm respectively in post-pubertal subjects. Although statistically insignificant, the maxillary width increase was more than that of the post-pubertal subjects by 0.6 mm. Over the long term, expansion produced permanent increases in the transverse dimensions of both the dento-alveolar and skeletal components of the maxilla and circum-maxillary structures in pre-pubertal subjects. The post-pubertal subjects presented with a statistically significant increase only in the later-nasal width by 1.3 mm than the untreated controls with no permanent increase in the skeletal maxillary width. CONCLUSION: The literature is very deficient regarding the use of skeletal age as a reference in the treatment of skeletal crossbites using RME. Only weak evidence exists supporting the increased maxillary and lateral-nasal widths after tooth-tissue borne RME in pre-pubertal subjects, with these effects being less in the post-pubertal ones.

2021 ◽  
Author(s):  
Bowen Zhang ◽  
Mengqiao Wang ◽  
Fenglu Zhao ◽  
Zijie Zhang ◽  
Fulan Wei

Abstract Background This study assessed the effects of rapid maxillary expansion (RME) on alveolar bone cortical thickness and vertical bone level of maxillary first molar. Material and methods PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and a manual search in reference lists of the included studies were searched up to November 2020. The data extraction and risk of bias assessment were performed independently by two authors. Review Manager 5 was used for quantitative analysis. Results Eight studies were selected for the systematic review, and six studies were statistically selected in meta-analysis. The thickness of the distal buccal alveolar bone was significantly reduced of both left (MD 0.53;95% CI:0.15–0.90) and right (MD 0.61;95% CI:0.28–0.94) sides of the maxillary first molar after RME. The same was true for the left (MD 0.63;95% CI:0.28–0.98) and right (MD 0.63;95% CI:0.36–0.91) sides of the mesial buccal side. And the vertical distance between the cusp tip and the buccal alveolar crest increased significantly after RME (SMD − 0.92;95% CI: -1.20–0.64). However, the study of palatal cortical thickness of maxillary first molar needs more clinical trials because of its high heterogeneity (left: I2 = 92%; right: I2 = 86%). Conclusions According to current studies, RME can reduce the buccal cortical thickness of maxillary first molars and increase vertical bone loss. More research is needed to determine the stability of the results. However, it is advisable to evaluate the alveolar bone before treatment.


2021 ◽  
pp. 105566562199336
Author(s):  
Akansha Bansal Agrawal ◽  
Harshavardhan Kidiyoor ◽  
Anand K. Patil Morth

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.


2016 ◽  
Vol 127 (7) ◽  
pp. 1712-1719 ◽  
Author(s):  
Macario Camacho ◽  
Edward T. Chang ◽  
Sungjin A. Song ◽  
Jose Abdullatif ◽  
Soroush Zaghi ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039366
Author(s):  
Luda Feng ◽  
Ning Liang ◽  
Tingting Li ◽  
Qinyu Yang ◽  
Ping Jiang ◽  
...  

IntroductionIntracerebral haemorrhage (ICH) is a life-threatening condition with no effective internal treatment options. However, edaravone is a promising therapeutic agent, although its beneficial effects are inconclusive based on previous systematic reviews and meta-analyses. While several trials in the last 8 years have reported the favourable long-term functional outcomes, a few reports indicated edaravone to be associated with an increase in adverse events.Methods and analysisThis protocol was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will perform the comprehensive and manual search for published articles, ongoing trials, dissertations and grey literature. The following databases will be searched from inception to 23 April 2020: Medline, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese scientific periodical database of VIP INFORMATION, Wanfang Data and SinoMed, with no language restrictions. All randomised controlled trials that (1) compared edaravone with placebo or no treatment, and (2) compared edaravone plus routine treatment or cointervention with routine treatment or cointervention for treating acute ICH will be included. Mortality and long-term dependency will be the primary outcomes. The incidence of adverse events will be assessed for safety evaluation. Two reviewers in pairs will independently carry out the article selection, data extraction and quality assessment. Assessment of the risk of bias and data synthesis will be performed using software Review Manager V.5.3. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of the overall evidence.Ethics and disseminationThere are no ethical considerations associated with this updated systematic review and meta-analysis. The findings will be disseminated in peer-reviewed journals or conference presentations.PROSPERO registration numberCRD42019147801.


Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 509
Author(s):  
Jorge Cortés-Bretón Brinkmann ◽  
Ignacio García-Gil ◽  
Patricia Pedregal ◽  
Jesús Peláez ◽  
Juan Carlos Prados-Frutos ◽  
...  

The aim of this study was to assess the long-term clinical behavior of straight implants in comparison with intentionally tilted dental implants (ITDI) supporting fixed restorations in partial or total edentulous arches, analyzing implant survival and success rates, complications, and marginal bone loss (MBL) after >5 years of function. An electronic search was conducted in five electronic databases (MEDLINE/Pubmed, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials) supplemented by a manual search. The electronic and manual search identified 1853 articles, of which 8 articles were selected for analysis. Out of a total of 3987 dental implants, 2036 were axial dental implants and 1951 tilted. Similar results were found in implant survival or overall implant success rates. Moreover, no statistically significant differences were found in MBL (p = 0.369; MD 0.116 mm (−0.137; 0.369) 95% CI) The prosthodontic/biological complications reported in the articles were very diverse and irregularly distributed. This systematic review suggests that there is no difference between tilted compared with straight dental implants in the medium-long term (>5 years). However, further research is needed to generate long-term data and confirm the present review’s findings.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247027
Author(s):  
Wei-Cheng Lee ◽  
Yi-Shing Shieh ◽  
Yu-Fang Liao ◽  
Cho-Hao Lee ◽  
Chiung Shing Huang

Background Maxillary protraction with or without expansion is a widely known orthopedic treatment modality in growing skeletal Class III patients. However, limited data are available regarding the outcomes of long-term changes in the maxilla. Aim of this meta-analysis was to assess the effectiveness of the long-term maxillary anteroposterior changes following a facemask therapy with or without rapid maxillary expansion in growing skeletal Class III patients. Methods A comprehensive literature search was conducted using the databases of PubMed, Science Direct, Web of Science, and Embase. Randomized controlled trials and cohort studies, published up to Sep. 2020, with maxillary protraction and/or expansion as keywords were included in this meta-analysis. Risk of bias within and across studies were assessed using the Cochrane tools (RoB2.0 and ROBINS-I) and GRADE approach. Overall and subgroup comparisons with the random-effect model were performed in this meta-analysis. Meta-regression models were designed to determine potential heterogeneity. Results There was a statistically significant increase (Mean difference, 2.29°; 95% confidence interval, 1.86–2.73; and p < 0.001 after facemask (FM) protraction. Mean difference, 1.73°; 95% confidence interval, 1.36–2.11; and p < 0.001 after rapid maxillary expansion(RME) and facemask protraction) in the Sella-Nasion-A point (SNA) angle in the treatment groups as compared with the control groups, when measured during the less than 3-year follow-up period. However, no statistically significant changes (Mean difference, 0.28°; 95% confidence interval, -0.57–1.13; and p = 0.52 after facemask protraction. Mean difference, 0.34°; 95% confidence interval, -0.64–1.33; and p = 0.50 after rapid maxillary expansion and facemask protraction) were observed in the SNA angle in the groups, when measured after 3 years of follow-up. Meta-regression analysis also showed that with increased follow-up duration, the effectiveness of maxillary protraction decreased. Conclusion This meta-analysis revealed that maxillary protraction therapy could be effective for a short-term in correcting maxillary hypoplasia and the treatment result was not affected by mean age and sex. However, with increased follow-up duration, the sagittal maxillary changes gradually decreased. Limitations on this review were only the SNA angle was used and clinical heterogeneity was not discussed. The quality of evidence was moderate. Further long-term observational studies are necessary for a comprehensive evaluation of the effects on maxillary skeletal changes.


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