Francisco Vale1, Mariana Albergaria2, Eunice Carrilho3, Inês Francisco2, Adriana Guimarães2, Francisco Caramelo4, Luísa Maló2. 1. Department of Orthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. Electronic address: fvale@fmed.uc.pt. 2. Department of Orthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 3. Department of Dentistry and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 4. Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Abstract
OBJECTIVE: The objective of this study was to assess the efficacy of rapid maxillary expansion (RME) in the treatment of OSAS in children and adolescents. METHODS: Five electronic databases were searched systematically: PubMed, Web of Science, LILACS, Embase and Cochrane Library. SELECTION CRITERIA: Randomized controlled trials, nonrandomized controlled trials, cohort studies, and systematic reviews published in English, Spanish, or Portuguese between January 2000 and December 2016, performed on children and adolescents younger than 18 years with OSAS who underwent RME, and assessing RME efficacy as measured by the Apnea-Hypopnea Index (AHI) normalization were included. Qualitative assessment of the selected studies was performed using Critical Appraisal Skills Programme checklists. Statistical evaluation included 2 meta-analyses and was based on a random-effects model and Cochran's Q test and I2 statistics to assess heterogeneity across the publications. Electronic searches identified 84 publications. Five publications were considered valid and included in this systematic review. RESULTS: Results from the meta-analysis show an overall reduction in AHI after RME therapy. CONCLUSIONS: Increasingly the evidence indicates that RME devices reduce AHI in children with OSAS, making RME therapy an appropriate alternative treatment option for these patients.
OBJECTIVE: The objective of this study was to assess the efficacy of rapid maxillary expansion (RME) in the treatment of OSAS in children and adolescents. METHODS: Five electronic databases were searched systematically: PubMed, Web of Science, LILACS, Embase and Cochrane Library. SELECTION CRITERIA: Randomized controlled trials, nonrandomized controlled trials, cohort studies, and systematic reviews published in English, Spanish, or Portuguese between January 2000 and December 2016, performed on children and adolescents younger than 18 years with OSAS who underwent RME, and assessing RME efficacy as measured by the Apnea-Hypopnea Index (AHI) normalization were included. Qualitative assessment of the selected studies was performed using Critical Appraisal Skills Programme checklists. Statistical evaluation included 2 meta-analyses and was based on a random-effects model and Cochran's Q test and I2 statistics to assess heterogeneity across the publications. Electronic searches identified 84 publications. Five publications were considered valid and included in this systematic review. RESULTS: Results from the meta-analysis show an overall reduction in AHI after RME therapy. CONCLUSIONS: Increasingly the evidence indicates that RME devices reduce AHI in children with OSAS, making RME therapy an appropriate alternative treatment option for these patients.
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