postGraduateThesis
Efeitos esqueléticos da expansão rápida e lenta da maxila em pacientes com fissuras labiopalatinas completas: uma revisão sistemática
Fecha
2019-06-03Registro en:
SILVA, João Pedro Dantas. Efeitos esqueléticos da expansão rápida e lenta da maxila em pacientes com fissuras labiopalatinas completas: uma revisão sistemática. 2019. 33f. Trabalho de Conclusão de Curso (Graduação em odontologia) - Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Natal, 2019.
Autor
Silva, João Pedro Dantas
Resumen
Introduction: Complete cleft lip and palate patients do not have the integrity of midpalatal suture and the enlargement of maxillary segments might be facilitated. Objective: The aim of this systematic review was to evaluate and compare the skeletal effects of rapid and slow maxillary expansion in patients with complete cleft lip and palate. Methods: Two reviewers performed a blind electronic search on the following databases: PubMed/Medline, LILACS, Cochrane, Scopus, Science Direct and Google Scholar. The search strategies used in these databases included the MeSH terms "palatal expansion technique", "cleft lip", and "cleft palate" and/or synonyms. Initially, the two examiners performed the search individually and selected the articles by reading the title and the abstract. The references of each selected article were manually searched in order to obtain unfound studies. In cases of disagreement regarding including or not a particular study, a discussion was held by the reviewers in order to reach a consensus or a third reviewer was required. Studies that met the inclusion criteria were qualitatively analyzed by means of a scale. The Kappa statistical test was used to evaluate inter-examiner agreement in two periods: after the selection of the articles and the qualitative analysis of the final studies. Results: Eight studies were selected. Both RME and SME promoted significant increases of nasal cavity width, maxillary width and alveolar width. Only RME promoted a significant increase of palatal volume. The palatal depth showed a non-significant decrease after RME and SME. No statistically significant differences were found between the changes of both expansion modalities. In general, the studies showed low to moderate risk of bias. Conclusion: Both RME and SME promoted similar skeletal effects in patients with complete cleft lip and palate. The difference between both expansion modalities seems to be related to treatment time, considered greater in cases treated with slow maxillary expansion. Further randomized clinical trials with similar methodologies are recommended in order to subside data to a future meta-analysis.