The Effectiveness of Alternating Rapid Maxillary Expansion and Constriction Combined with Maxillary Protraction in the Treatment of Patients with a Class III Malocclusion: A Systematic Review and Meta-analysis. (December 2018)

• Record Type: Journal Article
• Authors: Almuzian, Mohammed; McConnell, Elise; Darendeliler, M. Ali; Alharbi, Fahad; Mohammed, Hisham
• Is Part Of: Journal of orthodontics. Volume 45:Number 4(2018)
• Page Start: 250
• Page End: 259
• Publication Date: 2018-12
• Subjects: Systematic review -- meta-analysis -- Alt-RAMEC -- protraction facemask -- palatal expansion -- class III -- RCTs; Orthodontics -- Periodicals; 617.643005
• DOI: 10.1080/14653125.2018.1518187
• Languages: English
• ISSNs: 1465-3125

Abstract

Objectives: To establish the effectiveness of Alternate Rapid Maxillary Expansion and Constriction combined with Protraction Facial Mask (Alt-RAMEC/PFM) approach in treating Class III growing patients compared with PFM combined with conventional Rapid Maxillary Expansion (RME/PFM). Search sources: Unrestricted search in five electronic databases and manual searching were undertaken up to February 2018. Data selection: Randomised clinical trials (RCTs) evaluating the effectiveness of Alt-RAMEC/PFM were selected. Data extraction: Screening of references, data extraction and assessment of bias risk were evaluated independently by two reviewers. Results: Five RCTs comparing the Alt-RAMEC/PFM with RME/PFM met the inclusion criteria. Small but statistically significant mean differences favouring Alt-RAMEC/PFM protocol as measured by SNA angle (1.16°; 95% CI 0.65 to 1.66), SNB angle (0.67°; 95% CI 0.32 to 1.02) and ANB angle (0.66°; 95% CI 0.08 to 1.25) were noted. Alt-RAMEC/PFM exhibited a more favourable overjet correction when compared to RME/PFM, however, differences in other dental changes were insignificant. Conclusion: There is limited evidence with high risk of bias that Alt-RAMEC/PFM can result in a statistically significant increase in maxillary protraction compared with RME/PFM in Chinese subjects over the short-term. High-quality long-term RCTs with inclusion of patient-reported outcomes are required.