Systematic review of major considerations of rapid maxillary expansion

Abstract

Introduction: In the context of rapid maxillary expansion, transverse deficiencies are the main predictors of dentofacial deformities with high prevalence in dental practice. In this sense, the techniques of surgically assisted rapid maxillary expansion (SARME) and non-surgically assisted rapid maxillary expansion (NSARME) are used in order to correct maxillary development through palatal disjunction. Objective: to analyze the main considerations of rapid maxillary expansion, showing its main indications, contraindications, types of expanders, as well as the main dental and skeletal changes produced by them. Methods: We searched the databases EBSCO, SCIELO, PubMed / MEDLINE and Academic Google in the period 2003 to 2018. The main descriptors (Mesh Terms) were Rapid expansion of the maxilla, Rapid assisted surgery of the maxilla, Rapid non-surgical maxillary expansion, Circuit breakers and Clinical studies. Main Finding: The use of the Hyrax expander has become a poorly indicated procedure since the vast majority of patients with maxillary atresia also have other vertical and / or sagittal discrepancies in the bony bases of the face. In this context, however, the rapid expansion of the surgically assisted maxilla presents as a safe and easy procedure to be performed in the office, and is also a low-cost and acceptable procedure for patients. Conclusion: Based on the literary findings, there is still no consensus on which is the best jaw breaker, and it is necessary to increase the number of clinical and randomized studies, with eligibility criteria that can in fact homogenize the participants. In addition, the literature has clearly shown that it is imperative that dental surgeons have the knowledge and clinical experience to be able to indicate the best procedure for each patient, that is, the rapid expansion of the non-surgical or surgical maxilla.