The effectiveness of alternating rapid maxillary expansion and constriction combined with maxillary protraction in the treatment of patients with a class III malocclusion: a systematic review and meta-analysis.

Abstract

OBJECTIVES:

To establish the effectiveness of Alternate Rapid Maxillary Expansion and Constriction combined with Protraction Facial Mask (Alt-RAMEC/PFM) approach in treating Class III growing patients compared with PFM combined with conventional Rapid Maxillary Expansion (RME/PFM). Search sources: Unrestricted search in five electronic databases and manual searching were undertaken up to February 2018.

DATA SELECTION:

Randomised clinical trials (RCTs) evaluating the effectiveness of Alt-RAMEC/PFM were selected.

DATA EXTRACTION:

Screening of references, data extraction and assessment of bias risk were evaluated independently by two reviewers.

RESULTS:

Five RCTs comparing the Alt-RAMEC/PFM with RME/PFM met the inclusion criteria. Small but statistically significant mean differences favouring Alt-RAMEC/PFM protocol as measured by SNA angle (1.16°; 95% CI 0.65 to 1.66), SNB angle (0.67°; 95% CI 0.32 to 1.02) and ANB angle (0.66°; 95% CI 0.08 to 1.25) were noted. Alt-RAMEC/PFM exhibited a more favourable overjet correction when compared to RME/PFM, however, differences in other dental changes were insignificant.

CONCLUSION:

There is limited evidence with high risk of bias that Alt-RAMEC/PFM can result in a statistically significant increase in maxillary protraction compared with RME/PFM in Chinese subjects over the short-term. High-quality long-term RCTs with inclusion of patient-reported outcomes are required.

• Authors: Mohammed Almuzian, Elise McConnell, M Ali Darendeliler, Fahad Alharbi, Hisham Mohammed
• Journal: Journal of orthodontics (J Orthod) Vol. 45 Issue 4 Pg. 250-259 (12 2018) ISSN: 1465-3133 [Electronic] England
• PMID: 30252620 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Topics

• Cephalometry
• Constriction
• Extraoral Traction Appliances
• Humans
• Malocclusion, Angle Class III
• Maxilla
• Palatal Expansion Technique