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Efectividad de la expansión maxilar rápida quirúrgicamente asistida (SARPE): revisión sistemática
Resumen
DOI: https://doi.org/10.53766/AcBio/2023.13.25.09
La SARPE es un procedimiento quirúrgico para corregir discrepancias maxilares transversales en pacientes esqueléticamente maduros. Combina el uso de aparatos ortopédicos y ortodóncicos y osteotomías por distracción para lograr la expansión del maxilar y expansión controlada de tejidos blandos en poco tiempo. No se encontró una revisión sistemática actualizada en español sobre la efectividad de la SARPE para corregir discrepancias transversales y problemas subsecuentes en pacientes adultos. Por lo tanto, este artículo persigue determinar la efectividad de la SARPE en adultos con base en una revisión sistemática de la literatura publicada en los últimos años (2015-2023). Se realizó una búsqueda de artículos científicos bases de datos especializadas. Se identificaron 512 documentos y se incluyeron ocho ensayos clínicos y nueve revisiones sistemáticas, todos en inglés. Se encontró variabilidad en el diseño de los estudios respecto de las técnicas quirúrgicas, tipo de expansores, periodos de seguimiento y técnicas de evaluación imagenológica. Todas las modalidades de tratamiento aumentan significativamente el ancho del arco dentario y esquelético maxilar transversal comparando las mediciones iniciales y los seguimientos de control. Sin embargo, la SARPE que incluye disyunción pterigomaxilar fue la más efectiva para corregir discrepancias transversales y problemas funcionales y anatómicos asociados en pacientes adultos. Los estudios coinciden en que la evidencia disponible es insuficiente, debido a la ausencia de significancia estadística entre grupos. Por lo tanto, para confirma la efectividad y la estabilidad de la SARPE, se requieren más estudios clínicos controlados con periodos de seguimientos más largos, evaluados mediante 3D.
Recibido: 3/2/2023
Aceptado: 4/4/2023
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