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Home The effect of maxillary protraction, with or without rapid palatal expansion, on...

The effect of maxillary protraction, with or without rapid palatal expansion, on airway dimensions: A systematic review and meta-analysis

Authors:

  • M. Adobes Martin
    Department of Dentistry, Universidad Europea de Valencia, Spain
  • E. Lipani
    Department of Dentistry, Universidad Europea de Valencia, Spain
  • A. Alvarado Lorenzo
    Department of Dentistry, Universidad de Salamanca, Salamanca, Spain
  • L. Bernes Martinez
    Department of Dentistry, Universidad Europea de Valencia, Spain
  • R. Aiuto
    Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy - Istituto Stomatologico Italiano
  • M. Dioguardi
    Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
  • D. Re
    Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy - Istituto Stomatologico Italiano
  • L. Paglia
    Department of Paediatric Dentistry, Istituto Stomatologico Italiano, Milan, Italy
  • D. Garcovich
    Department of Dentistry, Universidad Europea de Valencia, Spain

DOI:

https://doi.org/10.23804/ejpd.2020.21.04.2

ABSTRACT


Aim

The use of maxillary protraction appliances (MPAs) and Facemask (FM), with or without a rapid maxillary expansion
(RME), have become a routine orthopaedic treatment procedure for the treatment of Class III in growing individuals; several authors
have suggested that maxillary protraction could have a positive impact on airway dimensions. The purpose of this systematic review and
meta-analysis was to assess the efficacy of maxillary protraction appliances (MPAs), with or without a rapid maxillary expansion (RME),
on airway dimensions in children in mixed or early permanent dentition.

Methods

An electronic search was
performed on PubMed, Medline, Scopus, The Cochrane Library, EMBASE and the System for Information on Grey Literature in Europe
until November 30th, 2019. The Newcastle-Ottawa (NOS) scale was used to assess the studies’ quality. Review Manager 5.3 (provided
by the Cochrane Collaboration) was used to synthesize the effects on airway dimensions.

Results

After full text assessment, 8
studies were included in the qualitative and quantitative synthesis. NOS scores ranged 6 to 9 indicating high quality. The effects of two
therapeutic protocols were compared, treatment with MPAs only (113 subjects treated - 65 controls) and the treatment with MPAs +
RME (137 subjects treated- 87 controls). The MPAs only treatment group displayed a significantly increase in nasopharyngeal airway
dimension at PNS-AD1 (random: mean difference, 1.39 mm, 95% CI, 0.32 mm, 2.47 mm, p= 0.01) and at PNS-AD2 (random: mean
difference, 1.70 mm, 95% CI, 1.14 mm, 2.26 mm, p= 0.00001). No statistically significant changes were found post treatment in MPAs +
RME treatment groups at PNS-AD1 (P= 0.15), PNS-AD2 (P= 0.17), McNamara’s upper pharynx (MPAs + RME P= 0.05, MPAs P= 0.99)
and McNamara lower pharynx (MPAs + RME P= 0.25, MPAs P= 0.40).

Conclusion

MPAs only treatment can increase the
pharyngeal thickness after treatment both at PNS-A1 and PNS-AD2. MPA+ RME had no effect on sagittal widths compared with
controls, but the effect on the transverse dimension could not be assessed.

PLUMX METRICS

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Publication date:

December /2020

Keywords:

airway dimensions, maxillary protraction, maxillary retrusion, rapid palatal expansion

Issue:

Vol.21 – n.4/2020

Page:

262 – 270

Publisher:

Ariesdue

Cite:


Harvard: M. Adobes Martin, E. Lipani, A. Alvarado Lorenzo, L. Bernes Martinez, R. Aiuto, M. Dioguardi, D. Re, L. Paglia, D. Garcovich (2020) "The effect of maxillary protraction, with or without rapid palatal expansion, on airway dimensions: A systematic review and meta-analysis", European Journal of Paediatric Dentistry, 21(4), pp262-270. doi: 10.23804/ejpd.2020.21.04.2
Vancouver: M. Adobes Martin, E. Lipani, A. Alvarado Lorenzo, L. Bernes Martinez, R. Aiuto, M. Dioguardi, D. Re, L. Paglia, D. Garcovich. The effect of maxillary protraction, with or without rapid palatal expansion, on airway dimensions: A systematic review and meta-analysis. European Journal of Paediatric Dentistry [Internet]. 2020Dec.1 [cited 2023Mar.23];21(4):262-270. Available from: https://www.ejpd.eu/abstract-pubmed/the-effect-of-maxillary-protraction-with-or-without-rapid-palatal-expansion-on-airway-dimensions-a-systematic-review-and-meta-analysis/
MLA: M. Adobes Martin, E. Lipani, A. Alvarado Lorenzo, L. Bernes Martinez, R. Aiuto, M. Dioguardi, D. Re, L. Paglia, D. Garcovich The effect of maxillary protraction, with or without rapid palatal expansion, on airway dimensions: A systematic review and meta-analysis. European Journal of Paediatric Dentistry. 2020;21(4):262-270

Copyright (c) 2021 Ariesdue

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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