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Maxillary transverse deficiency, with closed intermaxillary suture, does bone-anchored appliance during SARPE cause predictable, and stable maxillary expansion compared to the tooth-borne appliance during SARPE - Systematic review

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DOI: 10.1016/j.jormas.2022.11.020

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Dental; Crossbite; Palatal expansion technique

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This article discusses the challenges of managing maxillary transverse deficiency and presents a method of expanding the maxillary arch through closed intermaxillary suture. A systematic review found that bone-anchored appliances were more predictable and stable compared to tooth-borne appliances during SARPE.
Introduction: Managing maxillary transverse deficiency (MTD) with closed intermaxillary suture is a challenge in orthodontic treatment plans; over the years, clinicians have developed many approaches to treat this significant dentofacial deformity. Therefore, it is crucial to understand the underlying causes of MTD and to establish an effective treatment method for restoring the ideal aesthetics and functions for patients. A current and effective SARPE technique for expanding the maxillary arch involves performing 2-piece Le Fort I osteotomy to surgically apply horizontal force to the maxilla along the midpalatal suture in conjunction with either a tooth-borne or bone-borne appliance. Material and methods: A systemic review was conducted in order to investigate the differences between the two treatment methods for MTD with matured and closed intermaxillary suture: bone-anchored and toothborne appliance during SARPE (surgically-assisted rapid palatal expansion). The review was conducted in the English language through PubMed and Google Scholar electronic databases. The protocol is being reported in accordance with the PRISMA Statement. Results: This research, however, is subject to several limitations, including minimal randomization, limited sample size, indefinite measurement methods, and a short follow-up period. Each method of maxillary transverse deficiency therapy has been proven to be effective in expanding the maxillary arch. Conclusion: From the analysis of the articles, it was concluded that bone-anchored appliances have a more predictable and stable expansion compared to the tooth-borne appliance during SARPE. Nevertheless, further studies are needed to confirm its long-term effectiveness.

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