Postgraduate Program in Orthodontics, Department of Experimental and Clinical Medicine, The University of Florence, Italy.
Private Practice, Gorizia, Italy.
Eur J Orthod. 2021 Jun 8;43(3):301-312. doi: 10.1093/ejo/cjaa086.
No systematic review and meta-analysis of dento-skeletal effects following rapid maxillary expansion (RME) and slow maxillary expansion (SME) using the same jackscrew expander with different activation protocols is available.
To compare dento-skeletal effects produced by RME with those induced by SME using the same fixed jackscrew expanders in growing patients.
PubMed (MEDLINE), Cochrane Library, Scopus, Embase, and OpenGrey were searched with no language or publication date restrictions.
Only randomized controlled trials (RCTs) were selected and the following inclusion criteria were used: growing patients in mixed or permanent dentition, with maxillary transverse discrepancy, dental crowding, and treated with fixed jackscrew maxillary expander (e.g. Hyrax, Haas) activated to achieve either RME or SME.
Data were extracted by two independent reviewers. The quality of the included RCTs was assessed according to the Cochrane risk-of-bias tool for randomized trials (RoB 2.0). For the aggregation of continuous data, the mean of the differences (MD) between treatments was used. A random effect model was applied.
From 4855 retrieved articles, 3 studies were selected, 1 at unclear risk and 2 at high risk of bias. Maxillary intermolar distance showed no significant differences between the two modalities of expansion [pooled MD = 0.99 mm favouring RME, with 95% confidence interval (CI) = -2.09 to 4.06, P = 0.53, I2 = 90%]. As for maxillary molar inclination measured as the angle formed by the axes passing through the disto-buccal cusps and the apexes of the palatine root of the first upper molars, it was significantly smaller in the SME group (MD = -11.51°, with 95% CI = -15.23 to -7.79, P < 0.0001). Posterior maxillary expansion was significantly greater in RME than SME (pooled MD = 0.75 mm, with 95% CI = 0.27-1.23, P = 0.002, I2 = 0%).
Both RME and SME produce an effective dento-skeletal expansion of the maxilla. RME is slightly more effective in increasing the posterior transverse skeletal width of the maxilla while SME induces smaller molar inclination.
PROSPERO CDR42018105530.
目前尚无使用相同的螺旋扩弓器、不同激活方案的快速上颌扩张（RME）和慢速上颌扩张（SME）的牙颌骨骼效应的系统评价和荟萃分析。
比较使用相同的固定螺旋扩弓器治疗生长患者时 RME 和 SME 引起的牙颌骨骼效应。
无语言或出版日期限制地检索了 PubMed（MEDLINE）、Cochrane 图书馆、Scopus、Embase 和 OpenGrey。
仅选择随机对照试验（RCT），并使用以下纳入标准：混合或恒牙列的生长患者，上颌横向差异，牙齿拥挤，并使用固定螺旋扩弓器（例如 Hyrax、Haas）治疗以实现 RME 或 SME。
由两名独立评审员提取数据。根据 Cochrane 随机试验偏倚风险工具（RoB 2.0）评估纳入 RCT 的质量。对于连续数据的汇总，使用治疗之间差异的平均值（MD）。应用随机效应模型。
从 4855 篇检索到的文章中，选择了 3 项研究，其中 1 项为不确定风险，2 项为高偏倚风险。上颌磨牙间距离在两种扩张方式之间无显著差异[汇总 MD=0.99mm，RME 有利，95%置信区间（CI）= -2.09 至 4.06，P=0.53，I2=90%]。上颌磨牙倾斜度（以下颌颊尖和第一上颌磨牙腭根根尖形成的轴之间的角度表示）在 SME 组明显较小（MD=-11.51°，95%CI=-15.23 至-7.79，P<0.0001）。RME 比 SME 显著增加了上颌后向扩张（汇总 MD=0.75mm，95%CI=0.27-1.23，P=0.002，I2=0%）。
RME 和 SME 均可有效增加上颌牙颌骨骼的扩张。RME 在上颌后向骨宽度增加方面略有效，而 SME 引起的磨牙倾斜度较小。
PROSPERO CDR42018105530。
