Surgical Rapid Maxillary Expansion Research Articles

Do adjunctive interventions in patients undergoing rapid maxillary expansion increase the treatment effectiveness?

To evaluate the clinical effectiveness of adjunctive interventions in individuals undergoing rapid maxillary expansion (RME). MEDLINE, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar were searched without restrictions up to June 2020. Trials involving participants undergoing orthopedic or surgical RME, along with adjunctive interventions, were included. Risk-of-bias assessments were performed using the Cochrane tool for randomized trials-2. The certainty level of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool. Six randomized clinical trials, with low to high risk of bias, were included. Low certainty of the evidence suggested that low-level laser facilitated opening of the midpalatal suture during the active phase of RME. Likewise, moderate certainty demonstrated that low-level laser accelerated the healing process of the suture during the retention phase. The clinical impact of this outcome, that is, stability and retention time, was not evaluated. Very low evidence indicated that osteoperforations along the midpalatal suture increased maxillary transverse skeletal gains in young adults undergoing RME. Low evidence suggested that platelet-rich plasma therapy did not minimize the vertical and thickness bone loss after RME in the short term. Based on currently available information, the use of low-level laser associated with maxillary expansion seems to provide a more efficient suture opening and bone healing. Limited evidence suggests that osteoperforations improve the skeletal effects of RME in non-growing individuals. There are no adjunctive interventions capable of reducing the periodontal side effects of RME.

The effects of surgical rapid maxillary expansion (SRME) on vowel formants

The objective of this study was to investigate the effect of surgical rapid maxillary expansion (SRME) on vowel production. The subjects included 12 patients, whose speech were considered perceptually normal, that had undergone surgical RME for expansion of a narrow maxilla. They uttered the following Turkish vowels, ([ɑ], [ɛ], [ɯ], [i], [ɔ], [œ], [u], [y]), in isolation before and after the maxillary expansion. These samples were recorded for acoustical analysis. The fundamental frequencies (F0) and the frequencies and bandwidths of the first two formants (F1 and F2) of the vowels were measured using the Multi‐Speech programme (Kay Elemetrics). Statistical analysis revealed that the second formant frequency (F2) and bandwidth values in the vowel [i] and [œ] were lowered after maxillary expansion (p<.05). Surgical RME induced the decrease in the second formant of the [i] and [œ] vowels by affecting the size of the anterior oral cavity, however the influence was too small to cause any differences in the acoustic properties of the other vowels.