Non-Cochrane · intervention · PM41270444
Long-Term Effects of Three Different Appliances for Rapid Maxillary Expansion: A Systematic Review and Meta-Analysis.
Yu Jingyi, Qiu Feng, Xu Mengfei, et al. · International dental journal · 2026 · PubMed · doi:10.1016/j.identj.2025.104024
Findings
Population Growing patients (under 18 y) with maxillary transverse deficiency treated by nonsurgical rapid maxillary expansion
6 findings
| Tooth-borne (TB) rapid maxillary expander | Bone-borne (BB) rapid maxillary expander | Dental maxillary expansion 6 months post-expansion | MD -0.09 [-0.77, 0.59] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias 4 studies · 148 participants |
| Tooth-borne (TB) rapid maxillary expander | Bone-borne (BB) rapid maxillary expander | Skeletal maxillary expansion more than 1 year post-expansion | MD 0.10 [-0.94, 1.14] GRADE not reported 2 studies · 82 participants |
| Tooth-borne (TB) rapid maxillary expander | Bone-borne (BB) rapid maxillary expander | Skeletal maxillary expansion 6 months post-expansion | MD -1.24 [-4.34, 1.85] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias 3 studies · 108 participants |
| Tooth-borne (TB) rapid maxillary expander | Bone-borne (BB) rapid maxillary expander | Dental maxillary expansion more than 1 year post-expansion | MD 0.17 [-0.79, 1.12] GRADE not reported 2 studies · 82 participants |
| Tooth-borne (TB) rapid maxillary expander | Tooth-bone-borne (TBB) rapid maxillary expander | Skeletal maxillary expansion 6 months post-expansion | MD -0.24 [-1.46, 0.99] GRADE not reported 2 studies · 72 participants |
| Tooth-borne (TB) rapid maxillary expander | Tooth-bone-borne (TBB) rapid maxillary expander | Dental maxillary expansion 6 months post-expansion | MD 0.01 [-0.66, 0.69] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias 2 studies · 72 participants |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Altieri 2022 Comparison of changes in skeletal, dentoalveolar, periodontal, and nasal structures after tooth-borne or bone-borne rapid maxillary… PMID:34996663 | 2022 | this review only | Dental maxillary expansion; Skeletal maxillary expansion | not extracted yet |
| Bazargani 2021 Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances: a randomized controlled trial with 1-year… PMID:32761047 | 2021 | this review only | not stated | not extracted yet |
| Bazargani 2023 Three-dimensional comparison of tooth-borne and tooth-bone-borne RME appliances: a randomized controlled trial with 5-year follow-up. PMID:37253126 | 2023 | this review only | not stated | not extracted yet |
| Celenk-Koca 2018 Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial. PMID:30102085 | 2018 | this review only | Dental maxillary expansion | not extracted yet |
| Garib 2021 Orthopedic outcomes of hybrid and conventional Hyrax expanders. PMID:33434282 | 2021 | this review only | Dental maxillary expansion; Skeletal maxillary expansion | not extracted yet |
| Kayalar 2022 matched by author and year (probable) | NR | this review only | Dental maxillary expansion; Skeletal maxillary expansion | not extracted yet |
| Lagravere 2010 Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a… PMID:20197161 | 2010 | this review only | Dental maxillary expansion; Skeletal maxillary expansion | not extracted yet |
| Lagravere 2013 Transverse dental changes after tooth-borne and bone-borne maxillary expansion. PMID:23375921 | 2013 | this review only | Dental maxillary expansion; Skeletal maxillary expansion | not extracted yet |
| Mehta 2022 Long-term effects on alveolar bone with bone-anchored and tooth-anchored rapid palatal expansion. PMID:35272886 | 2022 | this review only | Dental maxillary expansion; Skeletal maxillary expansion | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Growing patients (under 18 y) with maxillary transverse deficiency treated by nonsurgical rapid maxillary expansion; at least 10 patients per study | Growing patients with transverse maxillary deficiency (n=9 studies, 7 data sets; mean ages about 11 to 14 y) |
| Intervention | Bone-borne or tooth-bone-borne rapid maxillary expansion | Bone-borne (BB) or tooth-bone-borne (TBB) expanders |
| Comparison | Tooth-borne rapid maxillary expansion | Tooth-borne (TB) expanders |
| Outcomes | Primary: dental maxillary expansion; additional: skeletal maxillary expansion, buccal bone reduction, molar angulation (three-dimensional evaluation by CT, CBCT or MRI) | Dental maxillary expansion (all studies), skeletal maxillary expansion (6 studies), buccal bone reduction (3 studies, not pooled), molar inclination (7 studies, not pooled) |
| Study designs | Randomized, quasi-randomized, prospective controlled, retrospective controlled and cohort studies | 6 RCTs, 2 retrospective studies, 1 parallel cohort study |
| Timing | Long-term measurements at least 6 months after expansion | 6 months post-expansion and more than 1 year (up to 5 years) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | No | no |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |