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

Area of Science:

• Orthodontics and Dental Research
• Craniofacial Development
• Regenerative Medicine

Background:

• Rapid maxillary expansion (RME) is a common orthodontic procedure to correct transverse discrepancies.
• Adjunctive interventions are explored to optimize RME outcomes and minimize side effects.
• Evidence on the efficacy of these adjunctive therapies remains under investigation.

Purpose of the Study:

• To systematically evaluate the clinical effectiveness of adjunctive interventions used with rapid maxillary expansion (RME).
• To synthesize current evidence regarding adjunctive therapies for orthopedic and surgical RME.
• To assess the impact of interventions on midpalatal suture maturation and skeletal changes.

Main Methods:

• Comprehensive literature search across multiple databases (MEDLINE, Web of Science, Scopus, etc.) up to June 2020.
• Inclusion of randomized clinical trials involving RME with adjunctive interventions.
• Risk-of-bias and certainty of evidence assessments using Cochrane RoB 2 and GRADE tools.

Main Results:

• Low-level laser therapy showed low certainty evidence for facilitating midpalatal suture opening and moderate certainty for accelerating bone healing during RME.
• Very low certainty evidence suggested osteoperforations increased maxillary transverse skeletal gains in young adults undergoing RME.
• Low certainty evidence indicated platelet-rich plasma did not minimize short-term bone loss after RME.

Conclusions:

• Low-level laser therapy appears to enhance suture opening and bone healing during RME.
• Osteoperforations may improve skeletal effects of RME in non-growing individuals.
• Currently, no adjunctive interventions are proven to reduce the periodontal side effects of RME.