Department of Orthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Department of Orthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
J Evid Based Dent Pract. 2017 Sep;17(3):159-168. doi: 10.1016/j.jebdp.2017.02.001. Epub 2017 Feb 14.
The objective of this study was to assess the efficacy of rapid maxillary expansion (RME) in the treatment of OSAS in children and adolescents.
Five electronic databases were searched systematically: PubMed, Web of Science, LILACS, Embase and Cochrane Library.
Randomized controlled trials, nonrandomized controlled trials, cohort studies, and systematic reviews published in English, Spanish, or Portuguese between January 2000 and December 2016, performed on children and adolescents younger than 18 years with OSAS who underwent RME, and assessing RME efficacy as measured by the Apnea-Hypopnea Index (AHI) normalization were included. Qualitative assessment of the selected studies was performed using Critical Appraisal Skills Programme checklists. Statistical evaluation included 2 meta-analyses and was based on a random-effects model and Cochran's Q test and I statistics to assess heterogeneity across the publications. Electronic searches identified 84 publications. Five publications were considered valid and included in this systematic review.
Results from the meta-analysis show an overall reduction in AHI after RME therapy.
Increasingly the evidence indicates that RME devices reduce AHI in children with OSAS, making RME therapy an appropriate alternative treatment option for these patients.
本研究旨在评估快速上颌扩张（RME）治疗儿童和青少年阻塞性睡眠呼吸暂停低通气综合征（OSAS）的疗效。
系统检索了 5 个电子数据库：PubMed、Web of Science、LILACS、Embase 和 Cochrane Library。
纳入 2000 年 1 月至 2016 年 12 月期间发表的、以儿童和青少年 OSAS 为研究对象、接受 RME 治疗且评估 RME 疗效的随机对照试验、非随机对照试验、队列研究和系统评价，评估 RME 疗效的指标为呼吸暂停低通气指数（AHI）正常化。采用批判性评价技巧项目清单对选定研究进行定性评估。统计评估包括 2 项荟萃分析，基于随机效应模型和 Cochran's Q 检验和 I 统计量来评估各出版物之间的异质性。电子检索共确定了 84 篇文献，其中 5 篇文献被认为有效并纳入本系统评价。
荟萃分析结果表明，RME 治疗后 AHI 总体降低。
越来越多的证据表明，RME 器械可降低 OSAS 儿童的 AHI，使 RME 治疗成为这些患者的一种合适的替代治疗选择。
