Evidence map›Paper›PMID 40604854›Full record

SynthesisBMC oral health2025

Effects of rapid maxillary expansion and functional orthodontic treatment in children with sleep disordered breathing: a systematic review.

Magdalena Piełunowicz, Jacek Kotuła, Krzysztof Kotuła, Mieszko Więckiewicz, Joanna Lis, Beata Kawala, Anna Ewa Kuc, Michał Sarul

Abstract readSystematic Review
In one paragraph

Synthesis in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Unraveling the Effects ofInternational journal of molecular sciences · 2025
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Magdalena PiełunowiczPiełunowicz Ortodoncja, Dzieci Warszawy 36, Warszawa, 02-495, Poland.
Jacek KotułaDepartment of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, Wroclaw, 50-425 , Poland. j_kotula@poczta.onet.pl.ORCID http://orcid.org/0000-0002-5781-6540
Krzysztof KotułaFaculty of Medicine of the Pomeranian Medical University in Szczecin, , Szczecin, Poland.ORCID http://orcid.org/0009-0008-8487-4675
Mieszko WięckiewiczDepartment of Experimental Dentistry, Wroclaw Medical University, Krakowska 26, Wroclaw, 50-425 , Poland.ORCID http://orcid.org/0000-0003-4953-7143
Joanna LisDepartment of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, Wroclaw, 50-425 , Poland.ORCID http://orcid.org/0000-0001-9192-1064
Beata KawalaDepartment of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, Wroclaw, 50-425 , Poland.
Anna Ewa KucDepartment of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, Wroclaw, 50-425 , Poland.
Michał SarulDepartment of Integrated Dentistry, Wroclaw Medical University, Krakowska 26, Wroclaw, 50-425, Poland.ORCID http://orcid.org/0000-0002-2518-0007

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleep disordered breathing (SDB) in children, characterized by sleep apnea episodes or other episodic or persistent breathing disorders, can be associated with the occurrence of some malocclusions. However, there are few clinical studies on the correlation of the occurrence of malocclusions and the effects of their treatment with reduction of SDB symptoms. Therefore, we conducted a systematic review of this topic, focusing on the population of children during the age of tooth replacement demanding orthopedic treatment for maxillary transverse growth deficiency and anterior mandibular growth modification. This systematic review seeks to assess effect on quality of sleep resulting from Rapid Maxillary Expansion and functional orthodontic treatment in patients with SDB and morphological changes occurring in the oral cavity and upper respiratory tract contributing to the reduction of SDB symptoms.

methodsThe review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 (PRISMA 2020). The study design was defined in the PICO format-Population (P): non-syndromic prepubertal and adolescent patients requiring orthodontic treatment, who additionally have coexisting sleep disorders; Intervention (I): Orthodontic treatment of malocclusion with differentiated appliances; Comparison (C): evaluation of Apnea Hypopnea Index (AHI) and sleep questionnaires pre and post treatment; Outcome (O): effect of orthodontic treatment on sleep quality. Search filters included the time of the publication-articles of 11 last years and publications that was published in English. The following variables were established for the selected articles: sample size, demographic characteristics, orthodontic treatment methods, type of study, AHI (Apnea-Hypopnea Index) parameter. The following scientific databases were searched: PubMed, Embase, Cochrane Central. The articles were analyzed for risk of bias and quality using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) protocol.

resultsAfter entering the keywords, 3,252 articles were retrieved. Of these, 16 articles were deemed eligible for systematic review and were thoroughly analyzed, of which 11 articles did not meet the inclusion criteria. Five articles (n = 248 individuals, 163 girls and 124 boys) aged 8-12.5 years, mean age 10.6, were included in the review. In 124 patients with class II malocclusions or mandibular retrognathia, a modification of the anterior growth of the mandible was used using Twin-Block appliances with the possible use of class II traction, and in 124 patients with bilateral crossbite, the Rapid Maxillary Expansion (RME) method was used. The quality of upper airway patency and sleep quality related to SDB was examined using polysomnographic analysis, polygraphy analysis, cephalometric studies and questionnaires.

conclusionsThe literature review suggests that orthodontic treatment may improve sleep quality, alleviate symptoms of SDB, and enhance sleep parameters however one article does not support this thesis. A close correlation between these phenomena has not yet been fully established. The current review is a good starting point for introducing simpler methods of examining the quality of sleep, in children, which requires further research on this topic. Registration CRD42024565669.

Indexed as

MalocclusionOrthodontics, CorrectivePalatal Expansion TechniqueSleep Apnea SyndromesAdolescentChildHumansFunctional applianceMalocclusionQuality of lifeSleep apnea in childrenSleep quality

Identifiers

PMID40604854
PMCPMC12224399

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.