Slow Maxillary Expansion Research Articles

Three-dimensional evaluation of dentoalveolar and skeletal transverse changes between rapid maxillary expansion and slow maxillary expansion in growing subjects – A systematic review and meta-analysis

Three-dimensional evaluation of dentoalveolar and skeletal transverse changes between rapid maxillary expansion and slow maxillary expansion in growing subjects – A systematic review and meta-analysis

Insertion guide for palatal TADs: Advantages and disadvantages from the clinical point of view

In recent years, there has been a growing trend in orthodontics to use the anterior palatal vault as an insertion site for temporary anchorage devices (TADs), to expand orthodontic possibilities and limit the collateral and unwanted dental effects. To improve accessibility and facilitate the procedure for clinicians, a guided approach for TAD insertion in the palatal vault, using insertion guides, has become increasingly prevalent. The manuscript primarily focuses on the real advantages and possible disadvantages that clinicians can expect when using insertion guides during TAD insertion into the palatal vault. Safety, precise evaluation of insertion depth, and the potential to execute a "one-visit protocol" are examined. Indeed, both direct and indirect palatal insertion protocols result to be efficient and safe in daily practice. The use of insertion guides result to be particularly beneficial for less experienced clinicians as well as for more complex patients and impacted teeth cases. Insertion guides can be created overlapping intraoral scanning to cbct or also to lateral teleradiograph, with sufficient accuracy and lower radiation exposure. However this method is limited in achieving bicortical evaluation, as well as relations to incisive canal and nasal floor. Finally a case report is presented, describing a full digital orthodontic treatment of a young adult patient presenting narrow maxilla. Slow maxillary expansion and fixed orthodontic treatment are described.

Effect of Slow Maxillary Expansion and Alternative Rapid Maxillary Expansion Protocols on Airway Volume in Cleft Palate Cases: A Cone Beam Computed Tomography Based Study.

A total of 22 patients with cleft palate aged 8 to 12 years were selected and categorized into two groups: the first group was treated with alternate rapid maxillary expansion and constriction (Alt-RAMEC) using an expander with differential opening (EDO) and facemask, while the second group was treated using slow maxillary expansion (SME) using an EDO. Finally, the pharyngeal airway volume in the two groups was compared using cone beam computed tomography (CBCT). CBCT scans were performed before expansion and six months following the expansion. Alveolar crest level, maxillary breadth, nasal cavity width, arch width, inclination of the molar teeth, buccal and palatal alveolar bone thickness, and maxillary alveolar width were all assessed. Paired t-tests (p=0.05) were applied to compare interphase data. The two groups showed a non-significant difference in terms of nasopharyngeal volume (cm3), oropharyngeal volume (cm3), and overall pre- and post-treatment results (p>0.005). Results of comparison of pre- and post-treatment periods in the Alt-RAMEC group revealed a significantly higher cleft volume (cm3) (p=0.001). Results of comparison of pre- and post-treatment periods in the SME group revealed a substantial rise in cleft volume (cm3) (p=0.003).Results from a comparison of the cleft volume (cm3) between the two study groups pre- and post-intervention revealed a non-significant difference (p=0.200 and 0.054, respectively).

Spontaneous Mandibular Dentoalveolar Changes after Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander-A Systematic Review.

This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.

Dental and Alveolar Arch Widths in Normal Occlusion and Class II Division 1 Malocclusion

This study was to evaluate and compare dental arch and alveolar widths of patients with Class II division one malocclusion with group of untreated normal occlusion subjects. This study was performed using measurement on dental casts of 30 normal occlusion and 30 Class II division 1 malocclusion of Iraqi sample aged 15-22 years. T-test was applied for comparing the groups , the finding of this study indicated that maxillary interpremolar width, maxillary canine, maxillary premolar and maxillary first molar and mandibular premolar and molar alveolar widths were found significantly narrower in the Class II division 1 group when compared with the normal occlusion sample (P<.001). The maxillary and mandibular intermolar and mandibular intercanine alveolar widths were statistically significantly larger in the Class II division 1 group ( P<.01) . Maxillary molar teeth in subjects with Class II division 1 malocclusion tend to incline to the buccal to compensate the insufficient alveolar base therefore rapid maxillary expansion rather than slow maxillary expansion should be considered during treat ment of Class II division 1 patients. The results of our study sugg ested that transverse discrepancy in Class II division one maloccl usion originated from upper posterior teeth and maxillary alveolar base.

Comparison of the effects on facial soft tissues produced by rapid and slow maxillary expansion using stereophotogrammetry: a randomized clinical trial

ObjectiveTo compare the effects on facial soft tissues produced by maxillary expansion generated by rapid maxillary expansion (RME) versus slow maxillary expansion (SME).Materials and methodsPatients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. A conventional RME screw was compared to a new expansion screw (Leaf expander) designed to produce SME. Both screws were incorporated in a fixed expander. The primary outcome was the difference of the facial tissue changes in the nasal area measured on facial 3D images captured immediately before application of the expander (T0) and after one year of retention, immediately after the expander removal (T1). Secondary outcomes were soft tissue changes of other facial regions (mouth, lips, and chin). Analysis of covariance was used for statistical analysis.ResultsFourteen patients were allocated to the RME group, and 14 patients were allocated to the SME group. There were no dropouts. Nasal width change showed a difference between the two groups (1.3 mm greater in the RME group, 95% CI from 0.4 to 2.2, P = 0.005). Also, intercanthal width showed a difference between treatments (0.7 mm greater in the RME group, 95% CI from 0.0 to 1.3, P = 0.044). Nasal columella width, mouth width, nasal tip angle, upper lip angle, and lower lip angle did not show any statistically significant differences. The Y-axis (anterior–posterior) components of the nasal landmark showed a statistically significant difference between the two groups (0.5 mm of forward displacement greater in the RME group, 95% CI from 0.0 to 1.2, P = 0.040). Also, Z-axis (superior-inferior) components of the lower lip landmark was statistically significant (0.9 mm of downward displacement in favor of the RME group, 95% CI from 0.1 to 1.7, P = 0.027). All the other comparisons of the three-dimensional assessments were not statistically significant.ConclusionsRME produced significant facial soft tissue changes when compared to SME. RME induced greater increases in both nasal and intercanthal widths (1.3 mm and 0.7 mm, respectively). These findings, though statistically significant, probably are not clinically relevant.Trial registration ISRCTN, ISRCTN18263886. Registered 8 November 2016, https://www.isrctn.com/ISRCTN18263886?q=Franchi&filters=&sort=&offset=2&totalResults=2&page=1&pageSize=10

Dentoskeletal effects of slow versus rapid maxillary expansion: a retrospective CBCT study

Dentoskeletal effects of slow versus rapid maxillary expansion: a retrospective CBCT study

Reply to Singh, G.D. Comment on "Dao et al. Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA). Pathophysiology 2023, 30, 199-208".

In response to the commentary "Response to 'Retrospective analysis of real-world data for the treatment of obstructive sleep apnea with slow maxillary expansion'" [...].

Comment on Dao et al. Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA). Pathophysiology 2023, 30, 199-208.

I found the recent article by Dao et al. titled "Retrospective analysis of real-world data for the treatment of obstructive sleep apnea with slow maxillary expansion using a unique expansion dental appliance (DNA)" [...].

COMPARING ARCH WIDTH, ALVEOLAR WIDTH ANDBUCCOLINGUAL INCLINATION OF POSTERIOR TEETH IN SUBJECTS WITH CLASS IANDCLASS II MALOCCLUSION

Aim: The aim of this study was to compare the arch width, alveolar width and buccolingual inclination of posterior teeth between Class I and Class II Div 1 malocclusion subjects. Materials and method: A sample of120 subjects (60 males and 60 females) in the age group of 16-19 years with Class I and Class II Div 1 malocclusion were chosen and arch width, alveolar width and buccolingual inclination of posterior teeth were measured and compared between the groups. Result: The maxillary posterior teeth showed more palatal inclination in Class II Div 1 malocclusion when compared with Class I group. Conclusion:Transverse discrepancy in Class II Div 1 might be due to more palatal inclination of maxillary posterior teeth rather than arch width and alveolar width. Hence slow maxillary expansion should be preferred for correcting the palatal inclination rather than rapid palatal expansion.

Relation between Maximum Oral Muscle Pressure and Dentoalveolar Characteristics in Patients with Cleft Lip and/or Palate: A Prospective Comparative Study.

Perioral muscle function, which influences maxillofacial growth and tooth position, can be affected in patients with oral clefts due to their inherent anatomical characteristics and the multiple surgical corrections performed. This research aims to (1) compare the maximum oral muscle pressure of subjects with and without isolated cleft palate (CP) or unilateral cleft lip and palate (UCLP), (2) investigate its influence on their dentoalveolar characteristics, and (3) investigate the influence of functional habits on the maximum oral muscle pressure in patients with and without cleft. Subjects with and without CP and UCLP seeking treatment at the Department of Orthodontics of University Hospitals Leuven between January 2021 and August 2022 were invited to participate. The Iowa Oral Performance Instrument (IOPI) was used to measure their maximum tongue, lip, and cheek pressure. An imbalance score was calculated to express the relationship between tongue and lip pressure. Upper and lower intercanine (ICD) and intermolar distance (IMD) were measured on 3D digital dental casts, and the presence of functional habits was reported by the patients. The data were analyzed with multivariable linear models, correcting for age and gender. 44 subjects with CP or UCLP (mean age: 12.00 years) and 104 non-affected patients (mean age: 11.13 years) were included. No significant differences in maximum oral muscle pressure or imbalance score were detected between controls and clefts or between cleft types. Significantly smaller upper ICDs and larger upper and lower IMDs were found in patients with clefts. A significant difference between controls and clefts was found in the relationship between oral muscle pressure and transversal jaw width. In cleft patients, the higher the maximum tongue pressure, the wider the upper and lower IMD, the higher the lip pressure, the smaller the upper and lower ICD and IMD, and the higher the imbalance score, the larger the upper and lower IMD and lower ICD. An imbalance favoring the tongue was found in cleft patients. The influence of functional habits on the maximum oral muscle pressure was not statistically different between clefts and controls. Patients with CP or UCLP did not present reduced maximum oral muscle pressure compared with patients without a cleft. In cleft patients, tongue pressure was consistently greater than lip pressure, and those who presented a larger maxillary width presented systematically higher imbalance scores (favoring the tongue) than those with narrow maxillae. Therefore, the influence of slow maxillary expansion on maximum oral muscle pressure in cleft patients should not be underestimated.

Three Dimensional Skeletal, Dentoalveolar and Airway Space Changes after Slow Maxillary Expansion in Children

The aim of this study was to investigate the effects of slow maxillary expansion (SME) on the dentoalveolar, skeletal, upper airway, and maxillary sinus using cone-beam computed tomography (CBCT). Twenty-three orthodontic patients (mean age 8.93 ± 1.61 years) who were treated with maxillary expansion using banded hyrax in the Department of Pediatric Dentistry at Jeonbuk National University Dental Hospital were included. According to the expansion speed applied, they were divided into two groups: SME (12 subjects, mean age 8.92 ± 1.45 years) and rapid maxillary expansion (RME, 11 subjects, mean age 8.94 ± 1.84 years). CBCT were obtained before (T0) and after (T1) the treatment and were analyzed with InVivo5 software (Anatomage, San Jose, CA, USA). Descriptive statistics showed no significant differences between the two groups in age, sex, or skeletal maturity. There were significant increases in maxillary width at the dentoalveolar and skeletal levels for both groups. Upper airway volume revealed a significant increase of 38.59% in the SME group and 28.72% in the RME group. However, there was no significant difference between SME group and RME group in all measurements. This study suggested the efficacy of SME in growing patients. SME was effective in increasing not only dentoalveolar and skeletal measurements but also airway volume. Therefore, pediatric dentists should select an appropriate expansion method considering the physiological aspects of periodontal tissues and discomfort in growing children.

Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA).

In addition to mandibular advancement devices, dental expansion appliances are an important clinical approach for achieving an increased intra-oral space that promotes airflow and lessens the frequency or severity of apneic events in patients diagnosed with obstructive sleep apnea (OSA). It has been thought that dental expansion in adults must be preceded by oral surgery; however, in this paper, we examine the results of a new technique for slow maxillary expansion without any surgical procedures. The palatal expansion device, DNA (Daytime-Nighttime Appliance), was reviewed in this retrospective study, particularly regarding its effects on measurements of transpalatal width, airway volume, and apnea-hypopnea indices (AHI) as well as its common modalities and complications. The DNA effectively reduced AHI by 46% (p = 0.00001) and significantly increased both airway volume and transpalatal width (p < 0.00001). After DNA treatment, 80% of patients showed some improvement in AHI scores with 28% of patients having their OSA symptoms completely resolved. Compared to the use of mandibular appliances, this approach is intended to create a sustained improvement in airway management that can reduce or eliminate dependence on continuous positive airway pressure (CPAP) or other OSA treatment devices.

Effect of three different maxillary expansion appliances on root resorption

Aim: The study was to examine rapid maxillary expansion (RME), semi-rapid maxillary expansion (SRME), and slow maxillary expansion (SME) compare the root resorptions occurring in the supporting upper first premolar teeth during treatment by using micro-computed tomography (micro-CT). Methodology: Thirty individuals that required maxillary expansion and upper first premolar tooth extraction were divided into three groups consisting of 10 individuals for RME, SRME, and SME. RME group, first premolar and first molar teeth with hyrax screw were activated ¼ tour twice daily with the banded hyrax appliances. SRME group, acrylic-bonded hyrax appliances were activated ¼ tour per morning and night until the opening of the suture. Upon the opening of the suture, it was activated ¼ tour per every two days until sufficient maxillary expansion was gained. SEM group, quad helix appliances were activated every 20 days. After 12 weeks of the retention period, the upper first premolar teeth were extracted. The teeth were scanned with Micro-CT (SkyScan 1172, Kontich, Belgium), and images were analyzed with a Dell Precision T5500 to determine the resorption crater volumes. Results: In all samples, the resorption craters were concentrated on the buccal surfaces of the tooth roots. The highest resorption craters volume, the total resorption volume, was observed in the RME group, followed by the SRME group, and the least resorption crater volume was detected in the SME group. Conclusion: Since the supporting teeth were exposed to more force on the root surfaces, the most resorption was seen in the RME group. How to cite this article: Topal R, Gündüz Arslan S. Effect of three different maxillary expansion appliances on root resorption. Int Dent Res 2023; 13(1):19-26. https://doi.org/10.5577/idr.2023.vol13.no1.4 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effect of Maxillary Expansion on the Maxillary Arch Width in Patients with Bilateral Cleft Palate: A Review.

To perform a comprehensive review of the literature to compare the effects of slow maxillary expansion (SME) and rapid maxillary expansion (RME) on maxillary arch width in patients with bilateral cleft palate. The databases include Medline, PubMed, Cochrane (CENTRAL) and (CDSR), OpenGrey, and ClinicalTrials.gov were searched for relevant studies that met the eligibility criteria published before or on 31 October 2022. The search was confined to the English language. The selection of eligible studies and collection of data were performed independently. Risk of bias assessment was conducted using the Cochrane Risk of Bias tool 2.0. Two randomized controlled trials were available based on the search in the published literature. Both studies compared arch width between SME and RME in cleft palate patients and digitals casts and three-dimensional images used for the evaluation. A moderate risk of bias was evident in the available studies. Both SME and RME can achieve similar amounts of maxillary expansion in patients with bilateral cleft palate.

Dimensional changes in the palate associated with Invisalign First System: a pilot study.

To compare palatal dimensions and molar inclinations after Invisalign First System (IFS) to those in patients treated with slow maxillary expansion (SME) and normal controls. Twenty-three mixed dentition patients treated with IFS were gender- and dental age-matched to another two groups: Haas-type SME and control group. The intercanine width (ICW), intermolar width (IMW), palatal surface area (SA), volume (V), and first molar buccolingual inclinations (MI) were measured before (T1) and after (T2) treatment. Analysis of variance was used to compare the differences among the three groups. The ICW increased significantly by 3.10 mm after IFS, 4.77 mm with SME, and 0.54 mm in controls; the difference among the groups was statistically significant (P < .001). The IMW increased by 1.95 mm in IFS, 4.76 mm in SME, and 0.54 mm in controls, with significant intra- and intergroup differences. Palatal SA and volume increased by 43.50 mm2 and 294.85 mm3 in the IFS group, which differed significantly from SME, but was similar to controls. The right and left MI increased 0.24° and 0.08° buccally, respectively, in the IFS group, which was comparable to controls, while significantly increased buccal MI was observed in the SME group. IFS expands the upper arch with increased ICW and IMW compared to controls, but the expansion amount is smaller than SME. Unlike SME, IFS has no effects on palatal dimensions and molar inclinations.

Comparison of alveolar bone thickness and height after slow expansion using quad-helix or clear aligners

ObjectiveThe study was conducted to investigate the thickness and height of the alveolar bone of individual teeth after slow maxillary expansion (SME) with quad helix or clear aligner appliances and hypothesized that there is no difference in buccal alveolar bone thickness or heights in patients treated by either quad helix or clear aligners. Material and MethodsThis is a retrospective study; the records of 22 patients treated between December 2019 to April 2020 by dental arch expansion using either clear aligners or quad helix appliances were retrieved and studied. The results obtained through cone beam computed tomography (CBCTs) before and immediately after maxillary expansion (2 + 1 mm per side) were analyzed (11 in the Quad Helix group and 11 in the clear aligner). The data collected was analyzed using linear and angular measurements obtained through On-demand 3D App software. Furthermore, Statistical Package for Social Sciences (SPSS) version 25.0 was used to present the findings by mean and standard deviations, and Scheffe’s test was applied for comparing forces. ResultsThe results showed that the mean age of patients in the clear aligner group and Quad Helix was 16.27 ± 0.56 years and 15.5 ± 1.53 years, respectively. There was no difference in buccal alveolar bone thickness or heights in patients treated by either quad helix or clear aligners. This is due to the findings that suggest that there was a decrease in bone height and bone width when treated with a quad helix as compared to clear alignment. ConclusionIt can be concluded that the quad helix SME treatment affects alveolar bone integrity; therefore, clear aligners might be better for treating patients than the quad helix.

Do patient-reported outcomes of miniscrew-supported maxillary expansion in adolescent patients differ between slow and rapid activation protocol?

Single-center randomized clinical trial with two parallel arms. The protocol of the study was approved by the institutional review board (IRB) of the Faculty of Dentistry, Alexandria University (IRB: 00010556-IORG: 0008839) and registered in Clinicaltrials.gov (identifier number: NCT04225637). Before the trial commencement, parents/legal guardians signed informed consents. The study complied with the CONSORT (Consolidated Standards of Reporting Trials). 30 adolescent patients aged between 12 to 16 years with transversely deficient maxilla requiring skeletal maxillary expansion were recruited to be included in the study. Patients received miniscrew-supported Penn expanders and they were randomly allocated (ratio 1:1) into two groups based on the activation protocol; slow maxillary expansion (SME = turn every other day) or rapid maxillary expansion (RME = 2 turn/day). The patient-reported outcome measures were the following: pain, headache, pressure, dizziness, speech, chewing and swallowing difficulties, swallowing difficulty. The participants rated the reported outcomes using numeric rating scale (NRS) at 4 time points: t1 = before appliance insertion, t2 = after first activation, t3 = after 1 week of activation, and t4 = after last activation. Patients were advised not to use analgesics, and to contact their provider in case of severe pain. Descriptive measures and patient-reported outcomes at various time points were calculated. Comparisons between the two groups at each time point were assessed using Mann-Whitney U-test. Comparisons of time points in each group were assessed using theFriedman test and followed by post-hoc tests with Bonferroni correction. 6 patients were not included in the analysis for different reasons, allowing a total of 24 patients (12 patients in each group) to be analyzed. Mean ages of the patients in the SME and RME group were 14.30 ± 1.37 and 15.07 ± 1.59, respectively. Median scores were in the bottom quartiles of NRS for all reported outcomes. RME group reported significantly higher scores for all measured variables, with exception of headache and dizziness, which showed no statistical difference between the two group. Mild to moderate discomfort and functional limitation is anticipated with the activation of miniscrew-anchored Penn expanders. Slow activation protocol provided a better overall patient experience when compared to a rapid activation protocol.

Maxillary Expansion and Its Effects on Circummaxillary Structures: A Review.

Transverse maxillary discrepancies are the most common. The narrowed upper arch is the most prevalent problem an orthodontist encounter while treating adolescent and adult patients.Maxillary expansion is a technique used to increase the upper arch's transverse dimension to apply forces to widen the upper arch. For young children, a narrow maxillary arch has to be corrected using orthopedic and orthodontic treatments. In an orthodontic treatment plan, it is crucial to update transverse maxillary defeat. There are various clinical manifestations associated with a transverse maxillary deficiency which include a narrow palate, crossbite mainly seen in posteriors (unilateral or bilateral), severe crowding in anterior teeth, and cone-shaped hypertrophy can be seen. Some frequently used therapies for constricted upper arch include slow maxillary expansion, rapid maxillary expansion, and surgically assisted rapid maxillary expansion. Slow maxillary expansion requires light and constant force, whereas rapid maxillary expansion needs heavy pressure for activation. The surgical-assisted rapid maxillary expansion has gradually become popular to correct transverse maxillary hypoplasia. The maxillary expansion has various consequences on the nasomaxillary complex. There are multiple effects of maxillary expansion on the nasomaxillary complex. Mainly, the effect is seen on the mid-palatine suture along with the palate, maxilla, mandible, temporomandibular joint, soft tissue, and anterior and posterior upper teeth. It also affects functions like speech and hearing. Information on maxillary expansion is provided in depth in the following review article, along with its various effects on the surrounding structure.

Stability of palatal rugae after orthodontic/orthopaedic expansion: a scoping review

Abstract Objective The palatal rugae are connective tissue located in the anterior third of the hard palate and present asymmetrically on each side of the palatine raphe. The stability and individualistic features of the palatal rugae have been suggested as an alternative human identification method in forensic medicine. However, there are different views about the tissue’s stability and reliability in individuals undergoing orthodontic expansion, as the palatal mucosa is stretched which likely alters palatal rugal morphology. The present review aims to summarise the available evidence regarding the stability of the palatal rugae after orthodontic expansion. Method Following the PRISMA-Scr guidelines, an extensive search was conducted using three databases (PubMed, Web of Science, and Scopus). Only studies that had control groups were included to allow for comparison. Results A total of six studies were identified. One report did not mention the type of expansion used, another used slow maxillary expansion (SME), and the other four used rapid maxillary expansion (RME). The results related to rugal length, morphological shape, and root mean square were inconclusive, likely because of data heterogeneity in expansion mechanics, the age of inclusion, and measurement outcomes. Conclusion More high-quality research is needed to substantiate the importance of palatal rugae in forensic medicine.