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Is maxillary expansion effective in treatment of obstructive sleep apnoea syndrome? A systematic review of systematic reviews

Evidence-Based Dentistry (2022)Cite this article

Abstract

Background Maxillary expansion (ME) might be beneficial in improving airway dimensions and obstructive sleep apnoea syndrome (OSAS) in patients with constricted maxillae. The aim of this overview is to present clinicians with a summary of the evidence. Data from systematic reviews and meta-analyses were evaluated to investigate the effect of ME on OSAS.

Methods An electronic search was commenced in five databases, in addition to a manual search until July 2021. Screening of articles started with title and abstract followed by full-text assessment. Systematic reviews with/without meta-analyses were included. Critical appraisal was done using A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Level of Research Design scoring and criteria of body of evidence scores. The search, study selection and critical appraisal were completed by three reviewers.

Results In total, 14 systematic reviews with/without meta-analyses were included. The quality of available evidence ranged between low to high, based on the overall quality evaluation.

Conclusions Based on the available evidence, maxillary expansion might be able to improve the nasal airway volume and OSAS in both growing and adult patients in the short term. ME can be considered as one of the treatment options in cases with OSAS.

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References

  1. Thilander B, Lennartsson B. A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition--occlusal and skeletal characteristics of significance in predicting the long-term outcome. J Orofac Orthop 2002; 63: 371-383.

  2. Harvold E P, Chierici G, Vargervik K. Experiments on the development of dental malocclusions. Am J Orthod 1972; 61: 38-44.

  3. Galeotti A, Festa P, Viarani V et al. Prevalence of malocclusion in children with obstructive sleep apnoea. Orthod Craniofac Res 2018; 21: 242-247.

  4. Abdullatif J, Certal V, Zaghi S et al. Maxillary expansion and maxillomandibular expansion for adult OSA: A systematic review and meta-analysis. J Craniomaxillofacial Surg 2016; 44: 574-578.

  5. Machado- Júnior A-J, Zancanella E, Crespo A-N. Rapid maxillary expansion and obstructive sleep apnoea: A review and meta-analysis. Med Oral Patol Oral Cir Bucal 2016; DOI: 10.4317/medoral.21073.

  6. Camacho M, Chang E T, Song S A et al. Rapid maxillary expansion for paediatric obstructive sleep apnoea: A systematic review and meta-analysis. Laryngoscope 2017; 127: 1712-1719.

  7. Vale F, Albergaria M, Carrilho E et al. Efficacy of Rapid Maxillary Expansion in the Treatment of Obstructive Sleep Apnoea Syndrome: A Systematic Review With Meta-analysis. J Evid Based Dent Pract 2017; 17: 159-168.

  8. Alper B S, Haynes R B. EBHC pyramid 5.0 for accessing preappraised evidence and guidance. Evid Based Med 2016; 21: 123-125.

  9. Page M J, McKenzie J E, Bossuyt P M et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; DOI: 10.1136/bmj.n71.

  10. Shea B J, Reeves B C, Wells G et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; DOI: 10.1136/bmj.j4008.

  11. Bucci R, D'Anto V, Rongo R, Valletta R, Martina R, Michelotti A. Dental and skeletal effects of palatal expansion techniques: a systematic review of the current evidence from systematic reviews and meta-analyses. J Oral Rehabil 2016; 43: 543-564.

  12. Antes G. Evidence-based medicine. Internist (Berl) 1998; 39: 899-908.

  13. Cooke IE, Sackett DL. Bailliere's clinical obstetrics and gynaecology. International Practise and Research. Evidence based obstetrics and gynaecology, vol 10, no 4, 1996. p. ix.

  14. Alyessary A S, Othman S A, Yap A U J, Radzi Z, Rahman M T. Effects of non-surgical rapid maxillary expansion on nasal structures and breathing: A systematic review. Int Orthod 2019; 17: 12-19.

  15. Niu X, Di Carlo G, Cornelis M A, Cattaneo P M. Three-dimensional analyses of short-and long-term effects of rapid maxillary expansion on nasal cavity and upper airway: A systematic review and meta-analysis. Orthod Craniofac Res 2020; 23: 250-276.

  16. Calvo-Henriquez C, Capasso R, Chiesa-Estomba C et al. The role of paediatric maxillary expansion on nasal breathing. A systematic review and metanalysis. Int J Paediatr Otorhinolaryngol 2020; DOI: 10.1016/j.ijporl.2020.110139.

  17. Calvo-Henriquez C, Megias-Barrera J, Chiesa-Estomba C et al. The Impact of Maxillary Expansion on Adults' Nasal Breathing: A Systematic Review and Meta-Analysis. Am J Rhinol Allergy 2021; 35: 923-934.

  18. Gordon J M, Rosenblatt M, Witmans M et al. Rapid palatal expansion effects on nasal airway dimensions as measured by acoustic rhinometry. A systematic review. Angle Orthod 2009; 79: 1000-1007.

  19. Baratieri C, Alves Jr M, de Souza M M G, de Souza Araújo M T, Maia L C. Does rapid maxillary expansion have long-term effects on airway dimensions and breathing? Am J Orthod Dentofac Orthop 2011; 140: 146-156.

  20. Buck L M, Dalci O, Darendeliler M A, Papageorgiou S N, Papadopoulou A K. Volumetric upper airway changes after rapid maxillary expansion: a systematic review and meta-analysis. Eur J Orthod 2017; 39: 463-473.

  21. Aziz T, Ansari K, Lagravere M O, Major M P, Flores-Mir C. Effect of non-surgical maxillary expansion on the nasal septum deviation: a systematic review. Prog Orthod 2015; 16: 15.

  22. Di Carlo G, Saccucci M, Lerardo G et al. Rapid Maxillary Expansion and Upper Airway Morphology: A Systematic Review on the Role of Cone Beam Computed Tomography. Biomed Res Int 2017; DOI: 10.1155/2017/5460429.

  23. Lee W-C, Tu Y-K, Huang C-S, Chen R, Fu M-W, Fu E. Pharyngeal airway changes following maxillary expansion or protraction: A meta-analysis. Orthod Craniofac Res 2018; 21: 4-11.

  24. Zeng X, Zhang Y, Kwong J S W et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: A systematic review. J Evid Based Med 2015; 8: 2-10.

  25. Murad M H, Asi N, Alsawas M, Alahdab F. New evidence pyramid. Evid Based Med 2016; 21: 125-127.

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Acknowledgements

The datasets used and/or analysed during the study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Lecturer, Department of Orthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt

    Mohamed Abd El-Ghafour & Amira Ahmed Aboalnaga

  2. Professor, Department of Orthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt; Professor, Department of Orthodontics, Faculty of Dentistry, Future University, Egypt

    Yehya Ahmed Mostafa

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  1. Mohamed Abd El-Ghafour
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  2. Amira Ahmed Aboalnaga
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  3. Yehya Ahmed Mostafa
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Contributions

Mohamed Abd El-Ghafour did the search, screened titles and abstracts, read the full text, critically appraised the included articles, drew the conclusions and wrote the manuscript. Amira Ahmed Aboelnaga repeated the search, screened titles and abstracts, read the full text, critically appraised the included articles, participated in drawing the conclusions and revised the manuscript. Yehya Ahmed Mostafa provided the idea of the article, acted as a judge when misconception arose between the two first reviewers, participated in drawing the conclusions and revised the manuscript.

Corresponding author

Correspondence to Mohamed Abd El-Ghafour.

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The authors declare no conflicts of interest.

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Abd El-Ghafour, M., Aboalnaga, A. & Mostafa, Y. Is maxillary expansion effective in treatment of obstructive sleep apnoea syndrome? A systematic review of systematic reviews. Evid Based Dent (2022). https://doi.org/10.1038/s41432-022-0283-6

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  • DOI: https://doi.org/10.1038/s41432-022-0283-6

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