Luísa Maló

Efficacy of Rapid Maxillary Expansion in the Treatment of Obstructive Sleep Apnea Syndrome: A Systematic Review With Meta-analysis

Objective The objective of this study was to assess the efficacy of rapid maxillary expansion (RME) in the treatment of OSAS in children and adolescents. Methods Five electronic databases were searched systematically: PubMed, Web of Science, LILACS, Embase and Cochrane Library. Selection Criteria Randomized controlled trials, nonrandomized controlled trials, cohort studies, and systematic reviews published in English, Spanish, or Portuguese between January 2000 and December 2016, performed on children and adolescents younger than 18 years with OSAS who underwent RME, and assessing RME efficacy as measured by the Apnea‐Hypopnea Index (AHI) normalization were included. Qualitative assessment of the selected studies was performed using Critical Appraisal Skills Programme checklists. Statistical evaluation included 2 meta‐analyses and was based on a random‐effects model and Cochrans Q test and I2 statistics to assess heterogeneity across the publications. Electronic searches identified 84 publications. Five publications were considered valid and included in this systematic review. Results Results from the meta‐analysis show an overall reduction in AHI after RME therapy. Conclusions Increasingly the evidence indicates that RME devices reduce AHI in children with OSAS, making RME therapy an appropriate alternative treatment option for these patients.

Aesthetic analysis of the face

Article history: Received 10 May 2016 Accepted 24 November 2016 Available online 30 March 2017 Objective: Using well-characterized sample of an european caucasian population, this study seeks to create lateral cephalometric information, based on the Natural Head Position within the assessed european population groups, to analyze sexual dimorphism and to study the comparison with similar work done in an american caucasian group. Methods: Fifty-five subjects (20 men and 35 women) were selected with the following criteria: caucasian descent, over 18 years old and presenting good facial aesthetics; Angle class I occlusion with no crowding and without temporomandibular disfunction; no previous history of orthodontic treatment or surgical interventions in the maxillofacial area. The following records were collected: (1) clinical data; (2) alginate impressions to obtain the study models; (3) four pictures in the Natural Head Position (NHP); (4) lateral cephalometric radiographs in centric occlusion and in the NHP. The american caucasian sample, 20 men and 26 women, were selected on the basis of the same criteria. Results: The thickness of the skin tissues that cover the face is larger in men than in women and there are no major ethnic differences. The total face height is significantly higher in men than in women, and is higher in european women compared to North-american women. The midface is further back sagittally in men than in women and is further back in the ideal european population versus the ideal american population. Conclusion: In a cephalometric analysis, we must consider the gender, age and etnic background of the patient in order to obtain correct clinical information.