Mandibular dental arch short and long-term spontaneous dentoalveolar changes after slow or rapid maxillary expansion: a systematic review

Arthur César De Medeiros Alves,Guilherme Janson,Olga Benário Vieira Maranhão,Daniela Gamba Garib

doi:10.1590/2177-6709.22.3.055-063.oar

Arthur César De Medeiros Alves, Guilherme Janson + Show 2 more

Open Access

https://doi.org/10.1590/2177-6709.22.3.055-063.oar

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Abstract

ABSTRACTObjective: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME) or rapid (RME) maxillary expansion in the mixed and early permanent dentitions. Methods:An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. Results:The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. Conclusions: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.

Highlights

Maxillary dental arch constriction is commonly associated with unilateral or bilateral posterior crossbites in the mixed or early permanent dentitions.[1,2] Considering that transverse malocclusions do not self-correct during the craniofacial growth, either slow (SME) or rapid (RME) maxillary expansions should be performed as early as possible to transversely increase the maxillary dental arch with a combination of orthopedic and orthodontic effects.[3,4] In general, the greater the patient’s age, the greater the dental effects and the smaller the skeletal changes.[5]Occasionally, maxillary constriction is not associated to posterior crossbites.[6]
Spontaneous progressive constriction of the mandibular dental arch might occur from childhood to adulthood as an adaptation process to the progressive maxillary constriction observed in untreated patients.[1]
This review was conducted based on the PRISMA Statement for Systematic Review[16] and comprised articles available until May of 2016

Summary

Introduction

Maxillary dental arch constriction is commonly associated with unilateral or bilateral posterior crossbites in the mixed or early permanent dentitions.[1,2] Considering that transverse malocclusions do not self-correct during the craniofacial growth, either slow (SME) or rapid (RME) maxillary expansions should be performed as early as possible to transversely increase the maxillary dental arch with a combination of orthopedic and orthodontic effects.[3,4] In general, the greater the patient’s age, the greater the dental effects and the smaller the skeletal changes.[5]Occasionally, maxillary constriction is not associated to posterior crossbites.[6]. Predominance of the tongue forces on the mandibular teeth might increase the mandibular dental arch width.[9]

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