@article{nokey,

title = {Facial soft tissue changes in patients following rapid maxillary expansion in children: A systematic review},

author = {Nafisa Marium Molla and Raisa Queiroz Catunda and Karla Carpio Horta and Heesoo Oh and Manuel O. Lagravère},

url = {https://www.sciencedirect.com/science/article/pii/S1761722725001421?pes=vor&utm_source=scopus&getft_integrator=scopus},

doi = {https://doi.org/10.1016/j.ortho.2025.101107},

year  = {2026},

date = {2026-06-01},

journal = {International Orthodontics},

volume = {24},

issue = {2},

abstract = {Background: Non-surgical rapid maxillary expansion (RME) has been widely investigated regarding skeletal effects, although fewer studies have assessed the associated soft tissue changes, which is an important factor to consider, as orthodontic treatment aims to achieve occlusal harmony and an aesthetically pleasing soft tissue balance. This systematic review examines the existing literature on facial soft tissue changes following rapid maxillary expansion (RME) in children with a maxillary transverse deficiency. Material and methods: A systematic search was conducted up to July 2025 in four major databases, including Embase (via Ovid), Medline (via Ovid), PubMed, Cochrane Library, and Google Scholar. Studies focused on children receiving RME were included. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for the Risk of Bias in Non-randomized Studies of Interventions. This review followed the protocols recommended by the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines. Results: Of the 1379 articles found, 15 included PICOS-based inclusion criteria: five randomized controlled trials, four cohort studies, and six controlled clinical trials. Alar width (0.5 to 2.21 mm), alar base width (0.17 to 2.81 mm), and nasolabial angle (0.9 degrees) increased significantly after RME treatment. Five studies were found to have a low risk of bias, seven had a moderate risk of bias, one had a serious risk of bias, and two had some concerns. Conclusions: Our findings suggest that RME results in variable soft tissue facial changes over time. The findings resulted statistically significant for alar width, alar base width, and nasolabial angle, showing changes in the facial soft tissues after non-surgical rapid maxillary expansion, especially in the nasal area. These results, which are directly related to the anatomical effects of the rapid maxillary expansion, need careful consideration by clinicians as the skeletal and the consequent soft tissue changes may be influenced by different factors, i.e. patient age, appliance activation and follow-up duration.},

keywords = {Facial Soft Tissue, implant supported rapid maxillary expansion, malocclusion, nasal changes, Rapid Maxillary Expansion, tooth-bone-borne rapid maxillary expansion},

pubstate = {forthcoming},

tppubtype = {article}

}

@article{Molla2025,

title = {Comparison of soft tissue facial changes in patients 7–11 years of age with and without maxillary expansion utilizing CBCTs and 3D facial scans: A preliminary study},

author = {Nafisa Molla and Heesoo Oh and Giseon Heo and Raisa Catunda and Manuel Lagravère},

url = {https://www.sciencedirect.com/science/article/pii/S1761722725000336?via%3Dihub},

doi = {https://doi.org/10.1016/j.ortho.2025.100998},

year  = {2025},

date = {2025-09-01},

urldate = {2025-09-01},

journal = {International Orthodontics},

volume = {23},

issue = {3},

abstract = {Background: The objectives of this study are to evaluate the effects of maxillary expansion over a period of 12 months on facial soft tissue measurements in children aged 7–11 years with a maxillary transverse deficiency of at least 5 mm or bilateral posterior crossbite, utilizing both CBCTs and 3D facial scans, by comparison to a control group. Material and methods: Data was collected from 32 patients and consisted of two groups: control and treatment (Hyrax expansion via RME, 1 turn/day). Each patient in each group underwent CBCTs, 3D facial scans and hand-wrist radiographs at two time points: pre-treatment (T0), and after the completion of expansion at post-retention (T1, 12 months). CBCTs were assessed using 3D Slicer software and 3D facial scans were assessed using OrthoInsight 3D software. The soft tissue measurements evaluated included the following: alar width, alar base width, mouth width, philtrum width, nasal tip prominence, nasolabial angle, upper lip to E-line, lower lip to E-line, upper lip height, height of vermillion of upper lip, lower lip height, height of nose, lower facial height and intercanthal width. Statistical analysis included intra- and inter-rater variability, measurement error calculation and MANOVA tests. Results: From a total of 32 patients with two sets of imaging records, no statistically significant differences were found between the two groups over the one-year observation. However, when comparing the two modalities utilized in this study (CBCT imaging and 3D facial scanning), the correlation was not as optimal for specific outcome variables such as alar base width and intercanthal width, potentially due to anatomic, imaging protocols and patient related factors. Conclusion: The findings of this study suggest that the children in both groups experienced similar facial soft tissue changes.},

keywords = {3D Imaging, Facial Soft Tissue, malocclusion, Rapid Maxillary Expansion},

pubstate = {published},

tppubtype = {article}

}