Abstract
The etiology of transverse maxillary deficiency is considered multifactorial, and has a deleterious effect on the bone development of the maxilla and nasal cavities, causing maxillary atresia and posterior crossbite. The objective of this systematic review was to compare in the scientific literature the effectiveness of the maxillary disjunction treated using dental distractor versus bone distractor. A systematic literature review was performed using the Science Direct, Embase, Cochrane Collaboration Library, and PubMed / MEDLINE databases. The search strategy provided a total of 119 studies. After screening by reading the titles and abstracts, seven articles met all the criteria and were included in this systematic review. Studies have shown that the choice of type of orthodontic-orthopedic appliance is directly related to the prior individualized planning of each patient. With regard to patients who are in the development phase, the recommendation is the use of dental maxillary expanders, such as the Hyrax appliance. In addition, it is not recommended to perform rapid maxillary expansion in adult patients, due to the expansion resistance that occurs in the palatine sutures. The treatment of patients with closed median palatine suture must be done by surgically assisted maxillary expansion.
Highlights
In order to establish an ideal occlusion, the upper dental arch needs to be proportionally larger than the lower dental arch, causing the palatal cusps of the premolars and maxillary molars to adequately adapt to the occlusal fossae of the premolars and mandibular molars
With regard to patients who are in the development phase, the recommendation is the use of dental maxillary expanders, such as the Hyrax appliance
The mechanism of action of Rapid maxillary expansion (RME) is based on the use of forces that are applied to the teeth and the alveolar process, causing the disjunction of the maxillary bones, expanding the median palatal suture (Canan, Şenişik., 2017)
Summary
In order to establish an ideal occlusion, the upper dental arch needs to be proportionally larger than the lower dental arch, causing the palatal cusps of the premolars and maxillary molars to adequately adapt to the occlusal fossae of the premolars and mandibular molars. Rapid maxillary expansion (RME) is indicated to treat conditions that are related to transverse maxillary deficiency, through the use of an orthodontic-orthopedic appliance in young patients, in which the process of ossification of the medial palatal suture has not been completed (Zhang et al, 2017; Sánchez et al, 2020). The mechanism of action of RME is based on the use of forces that are applied to the teeth and the alveolar process, causing the disjunction of the maxillary bones, expanding the median palatal suture (Canan, Şenişik., 2017). The principle of action of these devices is based on the use of an expander screw that is positioned transversely to the center of the palate, resting on the upper posterior teeth, with or without mucous support (Hassan et al, 2014; Alghamdi et al, 2017)
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