Effect of rapid maxillary expansion on sleep characteristics in children

Abstract

Introduction:Rapid maxillary expansion (RME) is an orthopedic treatment procedure routinely used to treat constricted maxillary arches and also a potential additional treatment in children presenting with sleep-disordered breathing (SDB).Aims and Objectives:The main objective of this study was to evaluate the effects of RME on sleep characteristics in children.Materials and Methods:Polysomnography was done on children of 8-13 years of age before expansion (T0), after expansion (T1) and after a period of 3 months after retention (T2). Bonded rapid maxillary expander was cemented in all children. Inter-molar distance was also measured at T0 and T2.Statistical Analysis:Nonparametric Friedman test was used for comparing the averages of sleep parameters at different time period (T0, T1, T2). Wilcoxon signed ranks test was used for comparing the averages of inter-molar width (T0-T2). P < 0.05 were considered as significant.Results:All children showed an improvement in sleep parameters with an increase in sleep efficiency, decreased in arousal and desaturation index after expansion. Total sleep time showed a statistically significant increase after expansion. A statistically significant increase in inter-molar distance was obtained after expansion.Conclusions:Rapid maxillary expansion is a useful treatment option for improving quality of sleep even in normal children without SDB. It also induces widening of the maxilla, corrects posterior crossbites and improves maxillary and mandibular dental arch coordination.

Effect of rapid maxillary expansion on sleep apnea-hypopnea syndrome in growing patients. A meta-analysis

“…Moreover, Katz et al (20) report an association between maxillary compression and SAHS. For this reason RME could be an effective therapeutic option and studies such as Zhao et al (21), using CBCT, have found that when maxillary compression is treated with RME, airway volume is enlarged in the nasal cavity and nasopharynx area (1) and the position of the tongue is improved contributing to increased space for the passage of air (1,21). So RME would appear to favor nasal respiration and could prevent airway obstruction (22).…”

“…Lastly, RME could have an important role to play in preventative treatment of SAHS in children (22). Early diagnosis is important to prevent the consequences of the syndrome (1).…”

“…According to the American Academy of Sleep Medicine, sleep apnea-hypopnea syndrome (SAHS) in children can be defined as multiple episodes in which obstruction of the upper airway (UA) is produced, impeding respiration during sleep. SAHS produces reductions in partial oxygen saturation, which induces a micro-awakening to reestablish normal oxygen flow (1). These events interrupt the normal structure of sleep and impede its reparative function (2).…”

A Therapeutic Alternative for Posterior Cross Bite in Adult Patients: Marpe

“…Uma má oclusão que tem sido um dos grandes desencadeadores de busca por terapia ortodôntica é a deficiência transversal maxilar. Esta condição é caracterizada por falta de crescimento e desenvolvimento transversal da maxila, promovendo uma MCP uni ou bilateral, presença de apinhamento dentário, apneia e até mesmo obstrução nasal (ASHOK et al, 2014;FÉLIX JUNIOR et al, 2020).…”

Impact of pediatric obstructive sleep apnea on the development of Class II hyperdivergent patients receiving orthodontic treatment:

“…[6][7][8] Along with the vast amount of research including animal experiments and literature reviews concerning airway and its influence on dentofacial growth and development, [9][10][11][12] many investigators have attempted to resolve pediatric OSAHS by the use of orthodontic appliances such as rapid maxillary expansion appliances. [13][14][15][16][17] However, few studies reported on the follow-up observation on the impact of OSAHS on patients treated with fixed orthodontic appliances.…”