Bone-Borne Maxillary Expansion and Traditional Rapid Maxillary Expansion: A Systematic Review and Meta-Analysis

The aim of this study was to perform a systematic review and meta-analysis to compare the effect of bone-borne expansion (BBE) and tooth-borne expansion (TBE) in patients with maxillary constriction.

Electronic databases, including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, were searched up to February 2019. Eligible clinical trials and cohort studies that studied the effects of bone-borne and tooth-borne expansion appliances on patients with constricted maxilla were selected. The study selection, data extraction, and risk of bias assessment were independently performed by two authors. Then, the random-effects meta-analysis and post-hoc heterogeneity tests were performed.  

In the end, four studies were included in the present meta-analysis (i.e., a randomized clinical trial, two prospective controlled clinical trials, and a cohort study) that collected data from 117 patients. The mean differences between TBE and BBE were 0.38 mm and -0.28 mm for premolar and molar apices, 0.67 mm and 1.18 mm for premolar and molar crowns, 0.19 mm and 0.17 mm for alveolar bone in premolar and molar areas, and -0.61 mm and 0.02 mm for nasal and maxillary bones, respectively. Moreover, the differences between TBE and BBE for dental angulation were 3.84◦ and 1.52◦ for left and right molars, as well as 4.85◦ and 3.46◦ for left and right premolars, respectively.

The BBE appliances do not have any advantages over tooth-borne devices with regard to the amount of skeletal or dental expansion; however, it seems to produce less tipping in posterior teeth.