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Meta-Analysis
. 2022 Dec 12;23(1):47.
doi: 10.1186/s40510-022-00440-5.

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

Valentina Rutili  1 , Michele Nieri  2 , Debora Franceschi  2 , Felicita Pierleoni  2 , Veronica Giuntini  2 , Lorenzo Franchi  3   4
Affiliations
Meta-Analysis

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

Valentina Rutili et al. Prog Orthod. .

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.

Keywords: Meta-analysis; Pain; Proms; Rapid maxillary expansion; Slow maxillary expansion; Systematic review.

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Conflict of interest statement

None of the authors have any competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 statement flowchart
Fig. 2
Fig. 2
Risk of bias of included studies
Fig. 3
Fig. 3
Forest plots of the outcomes included in the meta-analysis (A, presence of pain in 1st week; B, pain intensity in 1st week; C, presence of difficulty in speaking in 1st week)
Fig. 4
Fig. 4
Forest plots of the outcomes included in the meta-analysis (A, pain intensity in 2nd week; B, pain intensity in 3rd week; C, pain intensity in 4th week)
Fig. 5
Fig. 5
Forest plots of the outcomes included in the meta-analysis (A, presence of difficulty in swallowing in 1st week; B, presence of hypersalivation in 1st week; C, difficulty in hygiene in 1st week; D, patient satisfaction at 12th week; E, parent satisfaction at 12th week)
See this image and copyright information in PMC

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