Bucci Rosaria, Montanaro Danilo, Rongo Roberto, Valletta Rosa, Michelotti Ambra, D'Antò Vincenzo
Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy.
J Oral Rehabil. 2019 Apr;46(4):377-387. doi: 10.1111/joor.12766. Epub 2019 Feb 10.
Constricted maxilla is frequently associated with reduced nasal airway dimensions. Wheatear skeletal maxillary expansion (ME) is effective on the dimension of the upper airways is still a debated issue.
This overview aimed to report the evidence provided by systematic reviews (SRs) on the effect of ME on the upper airways and to assess the methodological quality of the included SRs.
Six electronic databases have been explored up to November 2017. After title and abstract screening, SRs addressing the effects of fixed palatal expanders on the dimension and function of the nasal airways were included. The methodological quality of the included SRs was assessed using the updated version of A Measurement Tool to Assess Systematic Review (AMSTAR-2).
Eight SRs were included. The methodological quality of most of the included SRs ranged between low and critically low. One SR was rated of high quality. A significant increase in nasal linear dimensions was reported both in the short and long term, but supported by low-/critically low-quality SRs. The significant increase in nasal cavity volume was the only outcome supported by a high-quality SR Controversial results were found with regards to nasal function.
Whenever a constricted maxilla is present general dentists, paediatricians and ENTs should be familiar with the potential improvement provided by ME. However, due to the low/critically low quality of SRs supporting these results, ME cannot be indicated only for upper airways enhancement, but should be supported by an orthodontic indication.
上颌骨狭窄常伴有鼻气道尺寸减小。麦氏骨内上颌扩弓术（ME）对上气道尺寸的有效性仍是一个有争议的问题。
本综述旨在报告系统评价（SRs）提供的关于ME对上气道影响的证据，并评估纳入的SRs的方法学质量。
截至2017年11月，检索了六个电子数据库。在进行标题和摘要筛选后，纳入了关于固定腭扩弓器对鼻气道尺寸和功能影响的SRs。使用更新版的系统评价评估测量工具（AMSTAR-2）评估纳入的SRs的方法学质量。
纳入了八项SRs。大多数纳入的SRs的方法学质量在低到极低之间。一项SR被评为高质量。短期和长期均报告鼻线性尺寸有显著增加，但证据质量为低/极低。鼻腔容积显著增加是唯一一项由高质量SR支持的结果。关于鼻功能，发现了有争议的结果。
只要存在上颌骨狭窄，普通牙医、儿科医生和耳鼻喉科医生都应熟悉ME可能带来的改善。然而，由于支持这些结果的SRs质量低/极低，ME不能仅用于改善上气道，而应有正畸指征的支持。
