The impact of different activation protocols of rapid maxillary expansion on external root resorption: a systematic review and meta-analysis

This comprehensive meta-analysis investigated the effects of Rapid Maxillary Expansion (RME) on external root resorption, which is a prevalent orthodontic treatment intended to correct transverse maxillary deficiency and constricted dental arches. By conducting a systematic literature search across prominent electronic databases, including the Cochrane Library, EMBASE, LILACS, MEDLINE, PubMed, and Web of Science, the study compiled evidence until April 2023. A spectrum of search terms was utilized to capture diverse aspects of root resorption, RME, palatal expansion methods, and tooth erosion. Registered with INPLASY (202430057), the meta-analysis meticulously screened 11 studies that fulfilled stringent inclusion criteria. The quality of these studies was assessed using the Cochrane Bias Risk Assessment Tool for Randomized Controlled Trials (RCTs) and the Methodological Index for Non-Randomized Studies (MINORS) for other research designs. The collective analyses disclosed a substantial impact of RME on external root resorption, indicating that the treatment may induce pronounced root erosion. Subgroup analyses further elucidated distinct patterns in root resorption among various types of RME, underscoring the variability in treatment outcomes and the need for personalized care. Consequently, the meta-analysis unequivocally confirmed that external root resorption may be a concerning consequence of RME treatment, necessitating thorough monitoring and management strategies to mitigate potential adverse effects on dental health.