Effects of rapid maxillary expansion on Down syndrome individuals

a systematic review


  • Talita Barros Sabino Universidade Federal de Minas Gerais
  • Matheus Henrique Guimarães Gualberto Moreira Universidade Federal de Minas Gerais
  • Tatiany Valente Roque Universidade Federal de Minas Gerais
  • Miriam Pimenta Vale Universidade Federal de Minas Gerais
  • Lucas Guimarães Abreu Universidade Federal de Minas Gerais https://orcid.org/0000-0003-2258-8071




Down syndrome, Rapid maxillary expansion, Systematic review


Objective: This systematic review sought to evaluate the effects of rapid maxillary expansion on individuals with Down syndrome.

Methods: Searches were conducted in four electronic databases (PubMed, Medline Ovid, Web of Science, and Scopus) to identify articles assessing the effects of rapid maxillary expansion on individuals with Down syndrome. Titles/abstracts were evaluated separately by two authors. Those who met the eligibility criteria were included. For those abstracts that presented insufficient information to reach a decision, the full text was retrieved. After the evaluation of the full texts, references that met the eligibility criteria were included. A manual search was also performed in the reference list of the articles included in this study. Data from the included articles were extracted. The quality evaluation of the studies was carried out with the Cochrane tool and MINORS.

Results: The search retrieved 289 references. After the removal of 37 duplicates, the titles/abstracts of 252 references were evaluated, and the eligibility criteria were applied. Of these 252 references, two met the eligibility criteria and were included. Six titles/abstracts did not have sufficient information for a decision, and a full text retrieval was necessary, none of which was included. In the first study, individuals with Down syndrome who underwent rapid maxillary expansion presented a significant improvement in the outcomes of snoring, mouth breathing, restlessness, waking up suddenly, drooling, articulation of words, tongue protrusion, and facial esthetics (p < 0.05) when compared with individuals in the control group. In the second, most individuals with Down syndrome undergoing rapid maxillary expansion present no complications.


Download data is not yet available.


Van Robays J. John Langdon Down (1828 – 1896). Facts Views Vis Obgyn. 2016;8(2):131-6.

Lejeune J, Turpin R, Gautier M. Mongolism; a chromosomal disease (trisomy). Bull Acad Natl Med. 1959 Apr 7-14;143(11-12):256-65.

Mégarbané A1, Ravel A, Mircher C, Sturtz F, Grattau Y, Rethoré MO, Delabar JM, Mobley WC. The 50th anniversary of the discovery of trisomy 21: the past, present, and future of research and treatment of Down syndrome. Genet Med. 2009 Sep;11(9):611-6.

Centers for Disease Control and Prevention [Internet]. Occurence of Down syndrome in the United States, 2017. Disponível em: https://www.cdc.gov/ncbddd/birthdefects/downsyndrome/data.html. Acesso em: 03 de dezembro de 2018.

Potier MC, Reeves RH. Editorial: Intellectual disabilities in Down syndrome from birth and throughout life: assessment and treatment. Front Behav Neurosci. 2016 Jun 14;10:120.

Pikora TJ, Bourke J, Bathgate K, Foley KR, Lennox N, Leonard H. Health conditions and their impact among adolescents and young adults with Down syndrome. PLoS One. 2014 May 12;9(5):e96868.

Korayem MA, Alkofide EA. Characteristics of Down syndrome subjects in a Saudi sample. Angle Orthod. 2014 Jan;84(1):30-7.

Marques LS, Alcântara CE, Pereira LJ, Ramos-Jorge ML. Down syndrome: a risk fator for malocclusion severity? Braz Oral Res. 2015;29:44.

Oliveira AC, Pordeus IA, Torres CS, Martins MT, Paiva SM. Feeding and nonnutritive sucking habits and prevalence of open bite and crossbite in children/adolescents with Down syndrome. Angle Orthod. 2010 Jul;80(4):748-53.

O'Neill J. Maxillary expansion as an interceptive treatment for impacted canines. Evid Based Dent. 2010;11(3):86-7.

Gurel HG, Memili B, Erkan M, Sukurica Y. Long-term effects of rapid maxillary expansion followed by fixed appliances. Angle Orthod. 2010;80 (1):5-9.

Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the Prisma statement. PLoS Med. 2009 Jul 21;6(7):e1000097.

Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011 Oct 18;343:d5928.

Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrumet. ANZ J Surg. 2003 Sep;73(9):712-6.

Moura CP, Andrade D, Cunha LM, Tavres MJ, Cunha MJ, Vaz P, et al. Down syndrome: otolaryngological effects of rapid maxillary expansion. J Laryngol Otol. 2008 Dec;122(12):1318-24.

Outumuro M, Abeleira MT, Caamaño F, Limeres J, Suarez D, Diz P, et al. Maxilary expansion therapy n children with Down syndrome. Pediatr Dent. 2010 Nov-Dec;32(7):499-504.

Koudstaal MJ, Van Der Wal KGH, Wolvius EB. Experience with the transpalatal distractor in congenital deformities. Mund Kiefer Gesichtschir. 2006 Sep;10(5):331-4.

Musich DR. Orthodontic intervention and patients with Down syndrome. Angle Orthod. 2006 Jul;76(4):734-5.

Pilcher ES. Treating the patient with Down syndrome. J Contemp Dent Pract. 2001 Nov 15;2(4):58.

Rey D, Campuzano A, Nzan P. Modified Alt-RAMEC treatment of Class III malocclusion in young patients with Down syndrome. J Clin Orthod. 2015 Feb;49(2):113-20.

Moura CP, Vales F, Andrade D, Cunha LM, Peschel SM, Clemente MP. Rapid maxillary expansion and nasal patency in children with Down syndrome. Rhinology. 2005 Jun;43(2):138-42.

Moura CP, Andrade D, Cunha LM, Cunha MJ, Vilarinho H, Barros H, et al. Voice quality in down syndrome children treated with rapid maxillary expansion. Interspeech. 2005;1073-76.

Oliveira ACB, Paiva SM, Campos MR, Czeresnia D. Factors associated with malocclusions in children and adolescents with Down Syndrome. Am J Orthod Dentofacial Orthop. 2008 Apr;133(4):489.e1-8.

Quintanilla JS, Biedma BM, Rodríguez MQ, Mora MTJ, Cunqueiro MMS, Pazos MA. Cefalometrics in children with Down’s syndrome. Pediatr Radiol. 2002 Sep;32(9):635-43.

Oliveira ACB, Czeresnia D, Paiva SM, Campos MR, Ferreira EF. Uso de serviços odontológicos por pacientes com síndrome de Down. Rev Saúde Pública. 2008;42(4):693-9.

Scalioni F, Carrada CF, Abreu L, Ribeiro RA, Paiva SM. Perception of parentes/caregivers on the oral health of children/adolescents with Down syndrome. Spec Care Dentist. 2018 Nov;38(6):382-390.

Andersson EM, Axelsson S, Katsaris KP. Malocclusion and the need for orthodontic treatment in 8-year-old children with Down syndrome: a cross-sectional population-based study. Spec Care Dentist. 2016 Jul;36(4):194-200.

Cozzani M,Guiducci A, Mirenghi S, Mutinelli S, Siciliani G. Arch width changes with a rapid maxilary expansion appliance anchored to the primary teeth. Angle Orthod. 2007 Mar;77(2):296-302.

Tanaka OM, Fornazari IA, Parra AX, de Castilhos BB, Franco A. Complete maxillary crossbite correction with a rapid palatal expansion in mixed dentition followed by a corrective orthodontic treatment. Case Rep Dent. 2016;2016:8306397.

Basciftci FA, Mutlu N, Karaman AL, Malkoc S, Kucukkolbasi H. Does the timing and method of rapid maxillary expansion have an effect on the changes in nasal dimensions? Angle Orthod. 2002 Apr;72(2):118-23.

Buck LM, Dalci O, Darendeliler MA, Papageorgiou SN, Papadopoulou AK. Volumetric upper airway changes after rapid maxillary expansion: a systematic review and meta-analysis. Eur J Orthod. 2017 Oct 1;39(5):463-73.

Chang Y, Koenig LJ, Pruszynski JE, Bradley TG, Bosio JA, Liu D. Dimensional changes of upper airway after rapid maxillary expansion: a prospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop. 2013 Apr;143(4):462-70.

Izuka EN, Feres MF, Pignatari SS. Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers. Dental Press J Orthod. 2015;20(3):43-9.

Babacan H, Doruk C, Uysal IO, Yuce S. Effects of rapid maxillary expansion on nasal mucociliary clearance. Angle Orthod. 2016 Mar;86(2):250-4.

Bauer D, Evans CA, Begole EA, Salzmann L. Severity of occlusal disharmonies in down syndrome. Int J Dent. 2012;2012:872367.

Barros ALO, Barros AO, Barros GLM, Santos MTBR. Burden of caregivers of children and adolescents with Down syndrome. Cienc Saúde Coletiva. 2018;22 (11):3625-34.

Kaye PL, Fiske J, Bower EJ, Newton JT, Fenlon M. Views and experiences of parents and siblings of adults with Down Syndrome regarding oral healthcare: a qualitative and quantitative study. Br Dent J. 2005;198(9):571-8.



How to Cite

Sabino, T. B., Moreira, M. H. G. G., Roque, T. V., Vale, M. P., & Abreu, L. G. (2019). Effects of rapid maxillary expansion on Down syndrome individuals: a systematic review. Arquivos Em Odontologia, 55. https://doi.org/10.7308/aodontol/2019.55.e10




Most read articles by the same author(s)

1 2 > >>