Effectiveness of adjunctive interventions in patients undergoing rapid maxillary expansion: An umbrella review

BackgroundRapid maxillary expansion is widely used to correct transverse maxillary deficiency; however, its biological limitations have led to the use of adjunctive interventions, with inconsistent evidence regarding their effectiveness.ObjectiveThis umbrella review aimed to evaluate the effectiveness of adjunctive interventions, including low-level laser therapy, platelet-rich plasma, and erbium-doped yttrium aluminum garnet laser-assisted osteoperforations, in patients undergoing rapid maxillary expansion and identify the best available evidence among conflicting systematic reviews.MethodsOnly systematic reviews and/or meta-analyses were included, while primary clinical studies (randomized controlled trials and non-randomized controlled trials) were excluded. The methodological quality of each review was evaluated utilizing the A Measurement Tool to Assess Systematic Reviews-2. The Jadad decision algorithm was employed to determine the best available evidence among the conflicting reviews.ResultsFive systematic reviews met the inclusion criteria. Low-level laser therapy demonstrated a significant improvement in osteodensity after 2 months; however, no significant differences were observed at 1 and 3 months. Evidence regarding osteoperforations and platelet-rich plasma remained limited and inconclusive.ConclusionBased on the currently available data, low-level laser therapy offers limited benefits for transverse maxillary expansion, with minimal effects on bone consolidation appearing after 3 months. The effectiveness of osteoperforations with rapid maxillary expansion is uncertain, and evidence for platelet-rich plasma as an adjunct therapy is lacking.