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Table 5 Summary of findings table according to the GRADE approach for the comparison of hybrid (tooth-bone-borne) versus tooth-borne rapid maxillary expansion

From: Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis

Trials (patients)
Anticipated absolute effectsa (95% CI)
Relative effect
(95% CI)
Tooth-borne RMEb Hybrid (tooth-bone-borne) RME Difference Quality of the evidence (GRADE)c What happens
External maxillary width at 1st molar
25 patients (1 trial)
2.0 mm 0.6 mm more
(1.4 less to 2.7 more)
⃝⃝⃝ lowd, e
due to bias, imprecision
Little to no difference in external maxillary width at 1st molars
Buccal tipping of 1st premolar
56 patients (2 trials)
3.7° 4.0° less
(0.9 to 7.1 less)
⃝⃝ moderatee, f
due to bias, imprecision
Probably less premolar tipping with hybrid RME
Buccal tipping of 1st molar
56 patients (2 trials)
4.3° 1.3° less
(3.6 less to 1.0 more)
⃝⃝ moderatee, f
due to bias, imprecision
Little to no difference in molar buccal tipping
Nasal resistance
30 patients (1 trial)
0.9 Pa s/cm3 0.2 Pa s/cm3 less(0 to 0.4 less) moderatee
due to imprecision
Probably lower nasal resistance with hybrid RME
Analgesic use on 1st expansion day
50 patients (1 trial)
RR 0.8
(0.3 to 1.8)
36.0% 28.1%
(12.2 to 63.4%)
7.9% less
(13.8% less to 27.4% more)
⃝⃝ due to imprecision
Little to no difference in analgesic use
  1. Bone-borne versus tooth-borne rapid maxillary expansion
  2. Population and intervention: adolescent or adult patients with skeletal maxillary deficit
  3. Settings: university clinics, private practices, and clinics (Canada, Netherlands, Sweden, Turkey)
  4. CI confidence interval, GRADE Grading of Recommendations Assessment, Development and Evaluation
  5. aThe basis for the risk in the control group (e.g., the median control group risk across studies) is provided in footnotes. The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  6. bResponse in the control group is based on average response of included trials
  7. cStarts from “high,” due to the inclusion of randomized studies
  8. dDowngraded by two points due to risk of bias (potentially inadequate randomization and lack of blind outcome assessment)
  9. eDowngraded by one point due to imprecision, as the optimal information size was judged not to be met
  10. fDowngraded by one point for risk of bias (lack of blind outcome assessment)