Does surgically assisted rapid maxillary expansion associated with pterygomaxillary disjunction result in changes in mandibular position? A PROSPERO-compliant systematic review of the literature.

Purpose: This study aimed to assess the effect of surgically assisted rapid maxillary expansion (SARME) associated with pterygomaxillary disjunction (PD) on mandibular positioning.

Materials And Methods: A two-phase systematic review registered with the PROSPERO database was performed. Search strategies were developed for specific databases (PubMed, Scopus, Web of Science, COCHRANE, LILACS, and DOSS), including the gray literature (Open Gray, Google Scholar, and ProQuest). The methodological and evidential quality of the included studies were assessed.

Results: Among 680 studies, four were selected for inclusion. In general, a low risk of bias was observed. The studies included a total of 142 adults, and used imaging to perform linear measurements (preoperatively and postoperatively). The main outcomes were maxillomandibular transverse index (difference between effective mandibular width - distance between the left and right antagonist points - and maxillary width), sagittal (forward and backward) and vertical (impaction and extrusion) changes, dental show, chin projection, and altered mandibular position.

Conclusion: Although the study demonstrated some mandibular position changes after SARME associated with PD, there is insufficient current evidence to support this result because of the potential study limitations related to the number of investigations chosen for inclusion. Further research is required to validate this finding.