Balasubramanian Shruti, Kalaskar Ritesh, Kalaskar Ashita
Department of Pediatric & Preventive Dentistry, Government Dental College & Hospital, Nagpur, Maharashtra, India.
Department of Oral Medicine and Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India.
Int J Clin Pediatr Dent. 2022 Sep-Oct;15(5):617-630. doi: 10.5005/jp-journals-10005-2421.
Rapid maxillary expansion (RME) has been extensively used in orthodontic practice for over a century, and it is claimed to benefit upper airway morphology. However, its effect in actually alleviating mouth breathing has remained unexplored. This systematic review was planned with an objective to provide a comprehensive synthesis of the effects of RME on upper airway volume and most importantly, its role in alleviating mouth breathing.
A literature search of electronic databases were done for the time period of 2000-2018. Randomized controlled trials (RCTs) and non-RCTs conducted on 8-15-year-old children who received bonded or banded RME and upper airway measured using three-dimensional (3D) imaging were included.
Twelve studies (two RCTs, nine nonrandomized clinical trials, and one non-RCT) were included in this systematic review, and nine studies were included for meta-analysis. Among the evaluated parameters, nasal cavity volume showed a significant increase which was maintained even after the retention phase, whereas nasopharyngeal and oropharyngeal volume did not report a significant change.
Based on this systematic review, it can be concluded that RME causes a significant increase in nasal cavity volume, but its effect on nasopharyngeal and oropharyngeal volume is not statistically significant in majority of studies. This increase in volume may not be considered as an equivalent for enhancement of airway and function unless proven so. In order to establish its significance in the improvement of breathing, it is necessary to conduct more well-designed RCTs with samples actually comprising mouth breathers.
Balasubramanian S, Kalaskar R, Kalaskar A. Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing. Int J Clin Pediatr Dent 2022;15(5):617-630.
快速上颌扩弓（RME）在正畸实践中已广泛应用了一个多世纪，据称其对改善上气道形态有益。然而，其在实际缓解口呼吸方面的效果仍未得到探索。本系统评价旨在全面综合RME对上气道容积的影响，最重要的是，探讨其在缓解口呼吸方面的作用。
对2000年至2018年期间的电子数据库进行文献检索。纳入对8至15岁接受粘结或带环RME治疗且使用三维（3D）成像测量上气道的儿童进行的随机对照试验（RCT）和非RCT。
本系统评价纳入了12项研究（2项RCT、9项非随机临床试验和1项非RCT），其中9项研究纳入荟萃分析。在评估的参数中，鼻腔容积显著增加，即使在保持期后仍保持增加，而鼻咽和口咽容积未报告有显著变化。
基于本系统评价，可以得出结论，RME可使鼻腔容积显著增加，但在大多数研究中，其对鼻咽和口咽容积的影响无统计学意义。除非得到证实，否则这种容积增加可能不能等同于气道和功能的改善。为了确定其在改善呼吸方面的意义，有必要开展更多设计良好的RCT，样本实际应包括口呼吸者。
Balasubramanian S, Kalaskar R, Kalaskar A. 快速上颌扩弓与上气道容积：快速上颌扩弓在口呼吸中作用的系统评价和荟萃分析。《国际临床儿科牙科学杂志》2022；15(5):617 - 630。
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