Evidence map›Paper›PMID 41781690›Full record

SynthesisSleep & breathing = Schlaf & Atmung2026

The effect of rapid maxillary expansion on children with obstructive sleep apnea: a systematic review and meta-analysis.

Keer Yu, Yaqi Li, Peter Ngan, Liang Li, Jiaxin Huang, Fang Hua, Tingting Zhao, Hong He

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Keer YuState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Yaqi LiState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Peter NganDepartment of Orthodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA.
Liang LiState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Jiaxin HuangState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Fang HuaHubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Tingting ZhaoState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China. zhaott1991@whu.edu.cn.
Hong HeState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China. drhehong@whu.edu.cn.

Funding

International Orthodontics Foundation IOF2022C01Sanming Project of Medicine in Shenzhen Nanshan SZSM202103005Wuhan University School & Hospital of Stomatology Clinical Research Project LYZX202101
6 · The paper itself

Abstract

purposePediatric obstructive sleep apnea (OSA) is a respiratory disorder that may lead to significant neurocognitive, behavioral, and cardiovascular dysfunction. Studies show rapid maxillary expansion (RME) widens the maxilla and nasal cavity, potentially reducing OSA symptoms. This systematic review and meta-analysis summarized recent the international literature on the efficacy of RME in alleviating pediatric OSA.

methodsAdhering to PRISMA guidelines and PROSPERO registration, we searched five databases (including PubMed and Embase) through March 2025. We included randomized and non-randomized studies assessing RME in children with PSG-diagnosed OSA. Risk of bias was evaluated using ROBINS-I, and evidence certainty via GRADE. Random-effects meta-analyses were performed for respiratory and radiological outcomes.

resultsMeta-analyses performed with RevMan software (version 5.4) revealed that the apnea-hypopnea index (AHI) decreased within six months following the completion of active RME (MD: -4.04, 95% CI: -6.39 to -1.70, P = 0.0007, I² = 93%) and within twelve months (MD: -6.15, 95% CI: -11.66 to -0.64, P = 0.03, I² = 97%). Additionally, a significant reduction in the Arousal Index was observed following maxillary expansion, while peripheral capillary oxygen saturation (SpO2%), total sleep time (TST), the lowest peripheral capillary oxygen saturation (Lowest SpO2%), and maxillary width demonstrated significant improvements at various time points after RME treatment.

conclusionsBased on the current evidence and its inherent limitations, these findings indicated that RME can effectively enhance the transverse width of the maxilla and improve polysomnographic parameters in pediatric patients with OSA. REGISTRATION: PROSPERO (CRD42025631528).

Indexed as

Palatal Expansion TechniqueSleep Apnea, ObstructiveChildHumansPolysomnographyPediatric obstructive sleep apneaPolysomnographyRapid maxillary expansionSystematic review

Identifiers

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Textmetadata
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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.