Tooth-borne versus bone-borne rapid maxillary expansion for transverse maxillary deficiency: A systematic review

Int Orthod. 2019 Sep;17(3):425-436. doi: 10.1016/j.ortho.2019.06.003. Epub 2019 Jul 4.


Purpose: The aim of this study was to compare dentoskeletal effects of bone-borne expanders with those of conventional expanders in adolescent and adults having transverse maxillary deficiency.

Methods: All randomized clinical trials (RCTs) comparing the effects of bone-borne with those of tooth-borne expansion for treatment of maxillary transverse deficiency in adults and adolescents with maxillary transverse deficiency or posterior crossbite were included. The systematic search was irrespective of language and publication type. The electronic search was conducted from 1980 to January 2018.

Results: The electronic searches retrieved 713 references after screening for eligibility criteria. Eight studies met the inclusion criteria for this systematic review involving 289 participants. Four studies compared rapid maxillary expansion (RME) between bone-borne and tooth-borne devices and indicated effectiveness of both devices on maxillary expansion. In the first molar region, there was no significant difference between two devices in either skeletal or dental expansion. Two studies compared the effects of bone-borne and tooth-borne device following SARME and suggested no significant difference regarding amount and pattern of expansion at various levels and in molar and premolar region between two groups. Two studies compared bone-borne and tooth-bone-borne devices.

Conclusion: Within the limit of the present evidence regarding maxillary expansion, it seems that both tooth-borne and bone-borne devices result in the same outcome in terms of the amount of maxillary expansion, dental tipping, stability and perceived pain both in RME and SARME procedure. PROSPERO registration: CRD42017061078.

Keywords: Ancrage dentaire; Ancrage osseux; Bone-borne; Disjonction maxillaire; Maxillary expansion; Revue systématique; Systematic review; Tooth-borne.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Databases, Factual
  • Dental Arch
  • Humans
  • Malocclusion / surgery
  • Maxilla / abnormalities
  • Maxilla / surgery
  • Molar
  • Orthodontic Anchorage Procedures / methods
  • Orthodontic Appliance Design
  • Orthodontic Appliances*
  • Palatal Expansion Technique* / instrumentation
  • Randomized Controlled Trials as Topic