Background Rapid maxillary expansion is widely used to correct transverse maxillary deficiency; however, its biological limitations have led to the use of adjunctive interventions, with inconsistent evidence regarding their effectiveness. Objective This umbrella review aimed to evaluate the effectiveness of adjunctive interventions, including low-level laser therapy, platelet-rich plasma, and erbium-doped yttrium aluminum garnet laser-assisted osteoperforations, in patients undergoing rapid maxillary expansion and identify the best available evidence among conflicting systematic reviews. Methods Only systematic reviews and/or meta-analyses were included, while primary clinical studies (randomized controlled trials and non-randomized controlled trials) were excluded. The methodological quality of each review was evaluated utilizing the A Measurement Tool to Assess Systematic Reviews-2. The Jadad decision algorithm was employed to determine the best available evidence among the conflicting reviews. Results Five systematic reviews met the inclusion criteria. Low-level laser therapy demonstrated a significant improvement in osteodensity after 2 months; however, no significant differences were observed at 1 and 3 months. Evidence regarding osteoperforations and platelet-rich plasma remained limited and inconclusive. Conclusion Based on the currently available data, low-level laser therapy offers limited benefits for transverse maxillary expansion, with minimal effects on bone consolidation appearing after 3 months. The effectiveness of osteoperforations with rapid maxillary expansion is uncertain, and evidence for platelet-rich plasma as an adjunct therapy is lacking.
Alhamwi et al. (Fri,) studied this question.