MANDIBULAR ARCH CHANGES FOLLOWING EXPANSION WITH SCHWARZ APPLIANCE IN GROWING PATIENTS – A SYSTEMATIC REVIEW.

Aim and Objectives The aim of this review is to systematically evaluate and assess the available evidence on arch dimensional changes in the mandible following expansion using Schwarz Appliance in growing patients. Materials and Methods The protocol for the review was registered with the PROSPERO database. A systematic search was done on the following scientific databases PubMed, Cochrane Central, LILACS and Google Scholar to identify articles of relevance published until April 2021. Articles that satisfied the inclusion criteria were included in the review. The review was performed based on the PRISMA guidelines. MINORS tool was used to evaluate the Risk of Bias and quality of evidence of the included studies. Results 243 trials were identified after implementing the search strategy. After eliminating duplicates 196 trials remained. After screening the titles and abstracts for the eligibility criteria, 190 trials were eliminated from further review. Full text was sought for the remaining six articles and one study was eliminated after review of the full text. Four the included studies showed low Risk of Bias in their methodologies and one study showed a low risk of Bias in its methodology. Qualitative analysis was performed on the remaining five trials. The studies significant increase in the Intermolar, intercanine, interpremolar and arch perimeter and also observed significant up righting of the permanent mandibular first molar. Conclusion Arch dimensional changes in the mandible of growing patients after expansion using Schwarz Appliance are dento-alveolar in nature. No skeletal Expansion is seen.