Skeletal, dentoalveolar and soft tissue effects of different maxillary expansion appliances in cleft lip/palate patients: A systematic review and frequentist network meta-analysis.

IF 2.2 3区医学 Q2 Dentistry

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-03-10 DOI:10.1016/j.jormas.2025.102312

Maged S Alhammadi, Fady Fahim, Reem Hassan Kelani, Areej Ali Alsaeedi, Basmah Hakam Mahdi, Najah Alhashimi, Esam Halboub, Abeer A Almashraqi

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引用次数: 0

Abstract

Introduction: This study aimed to assess the available evidence regarding the skeletal, dentoalveolar and soft tissue effects of different maxillary expansion appliances in cleft lip/palate patients.

Methods: We assessed the effects of different maxillary expansion appliances on skeletal structure and dentoalveolar and soft tissue in cleft lip/palate patients. We searched the PubMed, Science Direct, Web of Science, Cochrane, and LILACS databases through September 2024; that investigation was augmented by a manual search. We focused on clinical trials, either retrospective or prospective trials. The outcomes of interest included skeletal, dentoalveolar, and soft tissue changes obtained from study models, cephalometric radiographs, or cone beam computed tomography.

Results: Of the 430 screened articles, only six satisfied our eligibility criteria and were included in the quantitative synthesis. These articles exhibited a moderate overall risk of bias. None of the appliances conferred better forward skeletal maxillary movement than the hyrax. The iMini-M was the most effective appliance for increasing maxillary skeletal width (mean: 0.89 mm [range: 0.01-1.78 mm]), with the hyrax following closely behind. The Haas appliance exhibited the largest inter-molar distance (mean: 4.76 mm [range: 2.53-6.99 mm]), followed by the EDO, iMini-M and the hyrax. The fan-type appliance was the least effective at resisting maxillary premolar tipping (14.46° [2.60-26.32]), and the iMini-P was the most effective at reducing molar tipping (-3.54° [-6.06- -1.02]).

Conclusions: Considering the limited and moderate risk of bias, the iMini-M was the most effective appliance at increasing maxillary skeletal width compared with the hyrax; the Haas achieved the largest inter-molar distance. The fan-type appliance excelled at resisting premolar tipping, and the iMini-P offered the best control for molar tipping.

Registration: The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42023489536).

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.