Comparison of rapid versus slow maxillary expansion on patient-reported outcome measures in growing patients: a systematic review and meta-analysis.

IF 4.8 2区医学 Q1 Dentistry

Progress in Orthodontics Pub Date : 2022-12-12 DOI:10.1186/s40510-022-00440-5

Valentina Rutili, Michele Nieri, Debora Franceschi, Felicita Pierleoni, Veronica Giuntini, Lorenzo Franchi

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引用次数: 3

Abstract

Background: No systematic review and meta-analysis are present in the literature comparing patient-reported outcome measures (PROMs) in rapid maxillary expansion (RME) versus slow maxillary expansion (SME) in growing patients.

Objective: The objective of this systematic review was to compare PROMs in RME versus SME in growing patients.

Materials and methods: Electronic search in PubMed (MEDLINE), Cochrane Library, Scopus, Embase, Web of Science, and OpenGrey was conducted. Only RCTs were included. Inclusion criteria were: growing patients in the mixed dentition or early permanent dentition, mild-to-moderate maxillary transverse deficiency, dental crowding, treatment with fixed expanders for rapid and slow maxillary expansion. Risk of bias was assessed using RoB 2. GRADE statement was performed. The mean of the differences (MD) and the risk ratio (RR) were used for the aggregation of data. A random effect model was applied.

Results: Two articles with a total of 157 patients were finally included in the systematic review and meta-analysis. One article was at low risk of bias, while one was at risk of bias with some concerns. Pain presence was less, though not statistically significant, in SME patients (RR = 2.02, 95%CI from 0.55 to 7.49, P = 0.29, I² = 95%, 2 studies, GRADE very low). Pain intensity was significantly lower in SME appliance in the first week of treatment (pooled MD = 0.86 favoring SME, 95%CI from 0.47 to 1.26, P < 0.0001, I² = 6%, 2 studies, GRADE moderate). There were no significant differences between the two groups in difficulty in speaking, difficulty in swallowing, hypersalivation, difficulty in hygiene, and patient and parent satisfaction.

Conclusions: Pain intensity was significantly lower in SME compared to RME during the first week of treatment. For the following weeks, there were no differences in pain between the two protocols.

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快速与缓慢上颌扩张对生长患者报告结果测量的比较:一项系统回顾和荟萃分析。

背景:文献中没有系统回顾和荟萃分析比较患者报告的结果测量(PROMs)在快速上颌扩张(RME)和缓慢上颌扩张(SME)患者中。目的:本系统综述的目的是比较生长中的RME和SME患者的PROMs。材料和方法:在PubMed (MEDLINE)、Cochrane Library、Scopus、Embase、Web of Science和OpenGrey中进行电子检索。仅纳入随机对照试验。纳入标准为:生长在混合牙列或早期恒牙列的患者，上颌轻度至中度横向缺陷，牙齿拥挤，使用固定扩张器进行上颌快速和缓慢扩张。偏倚风险采用RoB 2进行评估。执行GRADE语句。采用差异均值(MD)和风险比(RR)进行数据汇总。采用随机效应模型。结果:两篇文章共157例患者最终被纳入系统评价和荟萃分析。一篇文章存在低偏倚风险，另一篇文章存在存在一些问题的偏倚风险。SME患者的疼痛发生率较低，但无统计学意义(RR = 2.02, 95% ci为0.55 ~ 7.49,P = 0.29, I2 = 95%， 2项研究，GRADE非常低)。在治疗的第一周，SME矫治器的疼痛强度显著降低(合并MD = 0.86, 95%CI从0.47到1.26,P 2 = 6%， 2项研究，GRADE中等)。两组患儿在说话困难、吞咽困难、唾液过多、卫生困难、患者和家长满意度方面均无显著差异。结论:在治疗的第一周，SME的疼痛强度明显低于RME。在接下来的几周内，两种方案之间的疼痛没有差异。

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来源期刊

Progress in Orthodontics Dentistry-Orthodontics

CiteScore

7.30

自引率

4.20%

发文量

审稿时长

13 weeks

期刊介绍： Progress in Orthodontics is a fully open access, international journal owned by the Italian Society of Orthodontics and published under the brand SpringerOpen. The Society is currently covering all publication costs so there are no article processing charges for authors. It is a premier journal of international scope that fosters orthodontic research, including both basic research and development of innovative clinical techniques, with an emphasis on the following areas: • Mechanisms to improve orthodontics • Clinical studies and control animal studies • Orthodontics and genetics, genomics • Temporomandibular joint (TMJ) control clinical trials • Efficacy of orthodontic appliances and animal models • Systematic reviews and meta analyses • Mechanisms to speed orthodontic treatment Progress in Orthodontics will consider for publication only meritorious and original contributions. These may be: • Original articles reporting the findings of clinical trials, clinically relevant basic scientific investigations, or novel therapeutic or diagnostic systems • Review articles on current topics • Articles on novel techniques and clinical tools • Articles of contemporary interest