TY - THES ID - 134735041 TI - Surgically Assisted and Rapid Maxillary Expansion: A systematic review and comparison of different types of expanders. AU - De Meurechy, Nikolas AU - Cadenas de Llano Perula, Maria AU - Willems, Guy. AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de tandheelkunde (Leuven) PY - 2018 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:134735041 AB - Introduction: A posterior crossbite is a frequent disturbance of the transversal relation between the upper and lower jaw. It can be uni- or bilateral and can have both a dental and skeletal cause. Since maxillary expansion as a treatment for this skeletal constriction was first reported, many new techniques and devices for expansion have been devised. Objectives: The aim of this systematic review is to compare the different appliances described in the scientific literature used for rapid maxillary expansion and to assess whether there is a difference in transversal expansion, dental, periodontal or skeletal effects, possible complications and success rates, in healthy non-syndromic patients. Materials and Methods: A computerized database search was performed using the databases PubMed Central, Web of Science and Cochrane Library. The reporting of this systematic review has been performed according to the PRISMA guidelines, with inclusion of RCT’s, non-randomized clinical trials, comparative and prospective studies, containing human patients without a craniofacial anomaly or syndrome who were treated for a posterior crossbite by either rapid or surgically assisted rapid maxillary expansion. The patient size had to be ten or more per treatment modality. The expanders included were teeth-, teeth-tissue- and bone-supported as well as hybrid expanders. If a simultaneous transversal and sagittal expansion was performed, the study was excluded. Furthermore, the article had to be written in Dutch, English, German or French. The risk of bias was assed using both the MINORS scale and Cochrane Collaboration’s tool. Results: Of a total of 1694 articles, 25 met all inclusion criteria. 14 out of these 25 studies were randomized controlled trials, 7 were non-comparative trials and 4 were comparative trials. Six studies compared the use of a tooth-borne expander with a tooth-tissue expander, four compared a tooth-borne distractor with a bone-borne distractor. Three studies compared the use of a tooth-borne distractor with a tooth-bone-borne distractor, while another three compared the use of a bonded hyrax to a banded Hyrax. Two compared the effects of a 2-banded and a 4-banded Hyrax. Three studies solely evaluated a bone-borne expander, one a Hyrax expander and one a Haas appliance. One study focused on an acrylic RME device, much alike a Haas appliance. One study evaluated the use of a Hybrid Hyrax. Conclusion: The Hybrid Hyrax appliance is the preferred treatment modality for (SA)RME in patients with a higher periodontal risk such as root resorption or buccal fenestrations of the bone. If a larger transversal expansion is needed and the patient shows no periodontal or dental risk factors, a tooth-borne appliance should be preferred when relying on RME and a bone-born appliance can be used in case of a SARME. ER -