The effects of pterygomaxillary disjunction in surgically assisted rapid maxillary expansion: A systematic review and meta-analysis.
Journal
Orthodontics & craniofacial research
Journal Volume
27
Journal Issue
5
Start Page
750
End Page
757
ISSN
1601-6343
Date Issued
2024-10
Author(s)
Abstract
Objective: This study aims to assess the expansive effects of pterygomaxillary disjunction (PMD) in surgically assisted rapid maxillary expansion (SARME) surgery using a meta-analysis approach. Materials and Methods: The study conducted a comprehensive literature search across five databases: PubMed, Scopus, Medline, Embase, and Cochrane, adhering to the PRISMA 2020 guidelines. Dental alterations were assessed using either cone-beam computed tomography (CBCT) or dental casts, while skeletal changes were exclusively measured from CBCT scans. We analysed the dentoskeletal changes between PMD +/− groups and conducted a within-group comparison. The primary focus of the results was on the mean differences observed in pre- and post-operative measurements. Results: Dental expansion was larger in the PMD+ group but not statistically significant. Skeletal expansion showed a significantly larger expansion in the posterior region in the PMD+ group (P =.033). Without PMD, anterior palatal expansion was significantly larger (P =.03), and the buccal tipping of posterior teeth was also significantly larger (P =.011) to achieve acceptable dental expansion outcomes. Conclusions: Both PMD +/− groups of SARME surgery can achieve satisfactory dental expansion outcomes. However, bone expansion and tooth inclination are also important factors that influence orthodontic treatment and post-expansion stability. By reducing the bony resistance with PMD, larger posterior palatal expansion and more parallel bony expansion are observed. In contrast, without PMD, there is smaller palatal expansion and greater tooth inclination in the posterior region. This could potentially lead to compromised periodontal conditions following expansion.
Subjects
meta‐analysis
orthodontics
palatal expansion technique
pterygomaxillary disjunction
surgically assisted rapid maxillary expansion
Type
journal article