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Effectiveness of miniscrew-assisted rapid maxillary expansion: a systematic review and meta-analysis

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Abstract

Objectives

To compare the effectiveness and side effects of miniscrew-assisted rapid maxillary expansion (MARME) with conventional rapid maxillary expansion (RME) in the treatment of transverse maxillary deficiency.

Materials and methods

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched in the MEDLINE, Embase, and Cochrane Central databases. The quality of included RCTs was evaluated using the Cochrane risk-of-bias tool. The primary outcome was the extent of dentoskeletal expansion achieved. Secondary outcomes were the dental and periodontal side effects. We calculated summary weighted mean differences (MD) with 95% confidence intervals (CI) using random-effects meta-analysis.

Results

Six RCTs involving 287 participants met the inclusion criteria. Compared to conventional RME, MARME was associated with a greater palatal suture opening (mm) measured at the anterior nasal spine (MD = 1.21, 95% CI 0.75 to 1.66), first premolars (MD = 1.13, 95% CI 0.72 to 1.55), first molars (MD = 1.18, 95% CI 0.28 to 2.09), and posterior nasal spine (MD = 1.14, 95% CI 0.30 to 1.98), increased palatal width (mm) at the first molars (MD = 0.75, 95% CI 0.30 to 1.20), and reduced buccal inclination (degrees) of the first premolars (MD =  − 6.06, 95% CI − 10.36 to − 1.76) and first molars (MD =  − 3.17, 95% CI − 5.35 to − 0.99).

Conclusions

MARME is associated with the following advantages over traditional tooth-borne RME: increased palatal suture opening, increased palatal width, and reduced buccal tooth inclination.

Registration

This study is registered with PROSPERO, CRD42021256750.

Clinical relevance

MARME may be preferred over conventional RME in cases with fused mid-palatal sutures or where further buccal tooth inclination is undesirable.

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Authors and Affiliations

  1. Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry, Western University, Dental Sciences Building, London, Ontario, N6A 5C1, Canada

    Wei Guang Bi

  2. Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada

    Kaiyang Li

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Correspondence to Wei Guang Bi.

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Appendix

Appendix

(Table 2 and Figs. 6, 7, 8)

Table 2 Search strategy
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Fig. 6
figure 6

Review authors’ judgements on each risk of bias category presented (A) cumulatively across all included studies as percentages; (B) separately for each study

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Fig. 7
figure 7

Comparing older patients who underwent SARME and younger patients who did not in interdental width change at the first premolars

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Fig. 8
figure 8

Comparing bone-borne and hybrid appliances in maxilla basal bone expansion at the first molars

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Bi, W.G., Li, K. Effectiveness of miniscrew-assisted rapid maxillary expansion: a systematic review and meta-analysis. Clin Oral Invest 26, 4509–4523 (2022). https://doi.org/10.1007/s00784-022-04415-y

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  • DOI: https://doi.org/10.1007/s00784-022-04415-y

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