Lo Giudice Antonino, Barbato Ersilia, Cosentino Leandro, Ferraro Claudia Maria, Leonardi Rosalia
Department of Biomedical and Dental Sciences and Morphofunctional Imaging-Section of Orthodontics, School of Dentistry, University of Messina, Italy.
Department of Medical-Surgical Specialties-Section of Orthodontics, School of Dentistry, University of Catania, Italy.
Eur J Orthod. 2018 May 25;40(3):296-303. doi: 10.1093/ejo/cjx057.
During rapid maxillary expansion (RME), heavy forces are transmitted to the maxilla by the anchored teeth causing buccal inclination and buccal bone loss of posterior teeth.
To systematically review the literature in order to investigate whether RME causes periodontal sequelae, assessed by cone-beam computed tomography (CBCT).
Fifteen electronic databases and reference lists of studies were searched up to March 2017.
To be included in the systematic review, articles must be human studies on growing subjects, with transversal maxillary deficiency treated with RME and with assessment of buccal bone loss by CBCT images. Only randomized and non-randomized trials were included.
Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics (study design, sample size, age, sex, skeletal maturity, type of appliance, daily activation, evaluated linear measurements, observation period, CBCT settings), and study outcomes (loss of buccal bone thickness and marginal bone) were reported according to the PRISMA statement.
On the basis of the applied inclusion criteria, only six articles, three randomized clinical trials and three controlled clinical trials were included. An individual analysis of the selected articles was undertaken. The risks of bias of the six trials were scored as medium to low.
The results of the present systematic review are based on a limited number of studies and only one study included a control group.
In all considered studies, significant loss of buccal bone thickness and marginal bone level were observed in anchored teeth, following RME. Further prospective studies correlating the radiological data of bone loss to the periodontal soft tissues reaction after RME are required. A preliminary evaluation of the patient-related risk factors for RR may be advisable when considering to administering RME.
This systematic review was registered in the National Institute of Health Research database with an appropriate protocol number (http://www.crd.york.ac.uk/PROSPERO Protocol: CRD42017062645).
The present study has not received any contributions from private or public funding agencies.
在快速上颌扩弓（RME）过程中，矫治力通过锚固牙传递至上颌，导致后牙颊倾和颊侧骨吸收。
系统回顾文献，以调查RME是否会导致经锥形束计算机断层扫描（CBCT）评估的牙周后遗症。
检索了截至2017年3月的15个电子数据库和研究的参考文献列表。
要纳入该系统评价，文章必须是关于生长发育期受试者的人体研究，采用RME治疗横向上颌骨发育不足，并通过CBCT图像评估颊侧骨吸收情况。仅纳入随机和非随机试验。
两名作者独立进行研究选择、数据提取和偏倚风险评估。根据PRISMA声明报告研究特征（研究设计、样本量、年龄、性别、骨骼成熟度、矫治器类型、每日加力、评估的线性测量指标、观察期、CBCT设置）和研究结果（颊侧骨厚度和边缘骨丧失情况）。
根据应用的纳入标准，仅纳入6篇文章，3篇随机临床试验和3篇对照临床试验。对所选文章进行了个体分析。6项试验的偏倚风险评分为中到低。
本系统评价的结果基于有限数量的研究，且仅有1项研究纳入了对照组。
在所有纳入的研究中，RME后锚固牙均出现了明显的颊侧骨厚度和边缘骨水平丧失。需要进一步进行前瞻性研究，将骨丧失的放射学数据与RME后牙周软组织反应相关联。在考虑实施RME时，对与RR相关的患者相关危险因素进行初步评估可能是可取的。
本系统评价已在英国国家卫生研究院数据库注册，注册号为（http://www.crd.york.ac.uk/PROSPERO Protocol: CRD42017062645）。
本研究未获得任何私人或公共资助机构的资助。
