Nunes Gabriel-Pereira, Morabito Maria-Juliana-Sismeiro-Dias, Nunes Larissa-Pereira, Capalbo Letícia-Cabrera, Prado Alexandre-Henrique-Dos Reis, de Toledo Priscila-Toninatto-Alves, Ferreira Mayra-Fernanda, Silva Arles-Naisa-Amaral, Martins Tamires-Passadori, Colombo Natália-Helena, Ferrisse Túlio-Morandin
Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
Laboratory for Bone Metabolism and Regeneration, University of Porto, Faculty of Dental Medicine, Porto, Portugal.
J Clin Exp Dent. 2024 Jun 1;16(6):e755-e771. doi: 10.4317/jced.61604. eCollection 2024 Jun.
This systematic review and meta-analysis aimed to evaluate if rapid maxillary expansion improves the activity of the masticatory muscles (masseter and temporal) in patients with unilateral posterior crossbite.
Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and grey literature. A manual search of orthodontic journals was also performed. Randomized clinical trials or longitudinal prospective studies were eligibles. Meta-analyses were conducted using R software with the "Meta" package, applying mean differences with a 95% confidence interval. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was evaluated using GRADE.
Nine articles were included. Qualitative analysis showed that RME treatment in patients with unilateral posterior crossbite showed a positive correlation with improvement in masseter and temporalis muscle activity. Meta-analyses indicated a significant difference for all models of muscle activity after treatment with rapid maxillary expansion, except for the temporal muscle in the force exerted on the maximum voluntary clenching on cotton rolls. The studies showed low bias risk, and the evidence certainty for each analysis was generally low to very low.
This investigation demonstrated the benefits of R rapid maxillary expansion in treating unilateral posterior crossbite and its potential therapeutic effects on the masticatory muscles. Rapid maxillary expansion, masticatory muscles, unilateral posterior crossbite, systematic review, meta-analysis.
本系统评价和荟萃分析旨在评估快速上颌扩弓是否能改善单侧后牙反合患者咀嚼肌（咬肌和颞肌）的活动。
检索了PubMed/MEDLINE、Scopus、Web of Science、Embase、Cochrane图书馆和灰色文献。还对手动检索正畸学杂志。纳入标准为随机临床试验或纵向前瞻性研究。使用R软件和“Meta”软件包进行荟萃分析，采用95%置信区间的平均差异。使用纽卡斯尔-渥太华量表评估偏倚风险，使用GRADE评估证据确定性。
纳入9篇文章。定性分析表明，单侧后牙反合患者的快速上颌扩弓治疗与咬肌和颞肌活动的改善呈正相关。荟萃分析表明，除了在最大自主咬紧棉卷时颞肌所施加的力外，快速上颌扩弓治疗后所有肌肉活动模型均存在显著差异。研究显示偏倚风险较低，每次分析的证据确定性一般为低到非常低。
本研究证明了快速上颌扩弓在治疗单侧后牙反合中的益处及其对咀嚼肌的潜在治疗效果。快速上颌扩弓、咀嚼肌、单侧后牙反合、系统评价、荟萃分析。
