This review aimed to evaluate and compare the skeletal and dental changes resulting from bone-borne (BB) versus tooth-borne (TB) surgically assisted rapid palatal expansion (SARPE) in patients with maxillary transverse deficiency (MTD). Eligible studies included randomized controlled trials, non-randomized trials, and cohort studies. A systematic search of PubMed®, Dentistry & Oral Sciences Source, CINAHL Plus, and Cochrane CENTRAL was performed for publications up to January 2023. Outcomes were calculated using weighted mean differences with 95 percent confidence intervals (CIs), and study heterogeneity was examined with Cochran’s I² test. Meta-analyses were conducted using RevMan v5.3.5.22. Seven studies, comprising a total of 249 participants who received SARPE with either BB or TB devices, were included in the review. Skeletal expansion in the first premolar and first molar regions was reported in five studies, revealing no significant difference between BB and TB approaches (mean difference: −0.16; 95 percent CI: −0.34 to 0.67). For dental expansion, all seven studies were analyzed, again showing no statistically significant differences between the groups (mean difference: −0.29; 95 percent CI: −0.77 to 0.19). Overall, the evidence indicates that both BB and TB SARPE appliances produce similar skeletal and dental expansion outcomes in patients with maxillary transverse deficiency, with no clear advantage of one approach over the other.
