Are there any potential risks or complications associated with maxillary arch expansion that are discussed in the literature ? (summary )

 

The article "Effects of Maxillary Arch Expansion: A Systematic Review of Systematic Reviews" provides a comprehensive overview of the craniofacial effects of maxillary expansion. The authors conducted a systematic review of systematic reviews and meta-analyses to summarize and critically appraise the available evidence concerning maxillary expansion treatment effects.

The authors identified 16 systematic reviews and meta-analyses that met their inclusion criteria. These studies evaluated the effects of maxillary expansion on various outcomes, including the transverse dimension of the maxillary and mandibular arches, mid-palatal suture, facial soft tissue, root resorption, periodontal health, circummaxillary sutures, nasal airway, TMJ, obstructive sleep apnea, and more. Overall, the authors found that maxillary expansion is an effective treatment for correcting transverse maxillary deficiency in both children and adults. The treatment can lead to significant increases in arch width and improvements in occlusion. However, there is some evidence to suggest that maxillary expansion may have negative effects on facial aesthetics in certain cases. The authors also found that there is limited evidence regarding the long-term stability of maxillary expansion outcomes. While some studies suggest that relapse may occur over time, others report stable outcomes up to 10 years post-treatment. In terms of potential risks or complications associated with maxillary expansion, the authors found that root resorption is a common side effect. However, most studies report only mild to moderate levels of root resorption that do not have significant clinical implications. Other potential risks include periodontal damage and TMJ pain or dysfunction. The authors note that there are several different protocols for performing maxillary expansion (e.g., rapid palatal expansion vs. slow palatal expansion), and it is unclear which protocol is most effective or has the fewest side effects. Additionally, there is limited evidence regarding the optimal timing of maxillary expansion treatment. Overall, the authors conclude that maxillary expansion is a safe and effective treatment for correcting transverse maxillary deficiency. However, they note that further research is needed to determine the optimal protocol for performing maxillary expansion and to evaluate the long-term stability of treatment outcomes. They also suggest that clinicians should carefully consider the potential risks and benefits of maxillary expansion when making treatment decisions for their patients.

What are the most common outcomes reported in the systematic reviews and meta-analyses included in this overview? 

The systematic reviews and meta-analyses included in this overview evaluated the effects of maxillary expansion on various outcomes. The most common outcomes reported were the transverse dimension of the maxillary and mandibular arches, mid-palatal suture, facial soft tissue, root resorption, periodontal health, circummaxillary sutures, nasal airway, TMJ, obstructive sleep apnea, and occlusion. These studies found that maxillary expansion is an effective treatment for correcting transverse maxillary deficiency in both children and adults. The treatment can lead to significant increases in arch width and improvements in occlusion. However, there is some evidence to suggest that maxillary expansion may have negative effects on facial aesthetics in certain cases.

Are there any potential risks or complications associated with maxillary arch expansion that are discussed in the literature?

Yes, there are potential risks or complications associated with maxillary arch expansion that are discussed in the literature. The most common side effect reported is root resorption, which can occur as a result of the mechanical forces applied during expansion. However, most studies report only mild to moderate levels of root resorption that do not have significant clinical implications. Other potential risks include periodontal damage and TMJ pain or dysfunction. It is important for clinicians to carefully consider the potential risks and benefits of maxillary expansion when making treatment decisions for their patients.

How might the findings of this overview inform clinical decision-making for orthodontic treatment?

The findings of this overview can inform clinical decision-making for orthodontic treatment in several ways. First, the evidence suggests that maxillary expansion is an effective treatment for correcting transverse maxillary deficiency in both children and adults. Therefore, clinicians may consider maxillary expansion as a treatment option for patients with this condition. Second, the evidence suggests that there are potential risks and complications associated with maxillary expansion, such as root resorption and periodontal damage. Clinicians should carefully consider these risks when making treatment decisions and monitor patients closely during and after treatment to minimize the risk of adverse effects. Third, the evidence suggests that there are different protocols for performing maxillary expansion (e.g., rapid palatal expansion vs. slow palatal expansion), and it is unclear which protocol is most effective or has the fewest side effects. Clinicians should consider the available evidence when selecting a protocol for their patients. Finally, the evidence suggests that there is limited evidence regarding the long-term stability of maxillary expansion outcomes. Clinicians should inform their patients about this uncertainty and monitor them closely over time to evaluate the stability of treatment outcomes. Overall, the findings of this overview can help clinicians make informed decisions about whether to recommend maxillary expansion as a treatment option for their patients with transverse maxillary deficiency and how to perform this treatment safely and effectively.