Rapid maxillary expansion and its consequences on the nasal and oropharyngeal anatomy and breathing function of children and adolescents: An umbrella review.

Abstract

To identify, qualify, and summarize the evidence from different systematic reviews about the outcomes of Rapid Maxillary Expansion (RME) on upper airway dimensions and breathing function in young patients. A literature search (from 2000 to December 2022) was conducted through PubMed (MEDLINE), the Cochrane Library, EMBASE, and Dentistry & Oral Science Source. The authors conducted the following umbrella review phases: research question, study selection criteria (systematic reviews involving randomized clinical trials and longitudinal observational designs), data extraction, and critical appraisal (bias risk assessment) of selected articles through the ROBIS tool. The initial search yielded 65 potential references. After screening titles and summaries, and the elimination of duplicated publications, 15 articles were eligible for the evaluation of the full-text document. Finally, 11 systematic reviews (5 combined with meta-analysis) were selected, reporting 132 single studies; 38 of them were unrepeatable. Risk-of-bias assessment showed an average global moderate/high quality among the included studies. There was high heterogeneity between the systematic reviews' (and meta-analyses') methodologies used. The present umbrella review concludes that significant and stable increases in the nasal and oropharyngeal space volumes and a decrease in airway resistance of growing children and adolescents, occur immediately after RME and at 3, 6- and 12-months follow-up.