Major clinical outcomes of rapid maxillary expansion in bucomaxillofacial surgery: a systematic review

Abstract

Introduction: The techniques of surgically assisted rapid maxillary expansion (SARME) and non-surgically assisted rapid maxillary expansion (NSARME) are used to correct maxillary development through palatal disjunction. Objective: It was analyzed using a systematic review of the literature on the main considerations of the rapid expansion of the maxilla, evidencing its main indications, contraindications, types of expanders, as well as the main dental and skeletal alterations by them produced. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 110 articles were found, 34 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 18 studies with a high risk of bias and 23 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=73.8%>50%. It was concluded there is still no consensus on which is the best jaw-breaker, and it is necessary to increase the number of clinical and randomized studies, with eligibility criteria that can homogenize the participants. In addition, the literature has clearly shown that bucomaxillofacial surgeons must have the knowledge and clinical experience to be able to indicate the best procedure for each patient, that is, the rapid expansion of the non-surgical or surgical maxilla.