Early interceptive treatment of anterior crowding in children in the early mixed dentition– a scoping review

Abstract Aims The objective was to comprehensively map existing literature on maxillary expansion in the early mixed dentition as an interceptive measure to treat anterior maxillary crowding in the absence of posterior crowding. Methods This scoping review was conducted according to the PRISMA-ScR guidelines and registered at the PROSPERO-register. Medline, Cochrane, Embase, and Web of Science were searched. Randomized, prospective and retrospective controlled trials were included if the maxilla was expanded and a change in arch perimeter was reported. Two reviewers screened and retrieved papers independently for eligibility and charted the data. Results The literature search identified 2176 studies, with 1241 abstracts screened. This process led to 30 studies undergoing full-text review, of which five were included. The included studies comprised one RCT, one prospective cohort study, and three retrospective cohort studies. All patients in these studies exhibited dental crowding and/or narrow dental arches. Various expansion modalities and protocols were employed. The studies reported changes in arch perimeter ranging from 0.9 to 6.15 millimetres. No harm or adverse effects were reported. Conclusions The existing body of evidence is limited by significant methodological heterogeneity. Given the inherent limitations of predominantly retrospective studies, maxillary expansion appears to increase the arch perimeter, thereby alleviating anterior crowding. Patient-reported outcomes were seldom evaluated. Future studies should consider utilizing qualitative research methodologies that incorporate an untreated control group in order to provide valuable insights and promote a more profound understanding of interceptive expansion in cases characterized by maxillary anterior crowding.