Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography study

Mordente, Carolina Morsani; Palomo, Juan Martín; Horta, Martinho Campolina Rebello; Souki, Bernardo Quiroga; Oliveira, Dauro Douglas; Andrade, Ildeu

doi:10.2319/032015-174.1

Cited by 20 publications

(15 citation statements)

References 22 publications

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“…Some previous morphological studies have reported nasal airway enlargement via RME in children with UCLP, but few functional studies of the nasal airways in children with UCLP have been reported. From these morphological studies and the morphological and CFD results of the current study, we conclude that RME improved ventilation of the nasal airway in children with UCLP by enlarging the nasal airway. Furthermore, nasal septum deviation in children with UCLP was reduced at T2.…”

Section: Discussionmentioning

confidence: 98%

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Rapid maxillary expansion effects of nasal airway in children with cleft lip and palate using computational fluid dynamics

Iwasaki

Yanagisawa‐Minami

Suga

et al. 2019

Orthod Craniofacial Res

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The craniofacial morphology of children with unilateral cleft lip and palate (UCLP) differs from that of children without clefts. 1 Maxillary arch constriction is frequently observed in operated patients with UCLP. 2 Therefore, rapid maxillary expansion (RME) is often required in children with UCLP; in children without clefts, improvements in nasal airway ventilation and dentition expansion may be required. 3 However, improvements in nasal airway ventilation associated with RME in children with UCLP are unclear, particularly in cases involving nasal airway ventilation obstruction. 4 In studies investigating RME in patients with UCLP, the volume 5 and cross-sectional area 6 of the nasal airway reportedly increase. However, nasal septum deviation and the other nasal airway forms are often associated with abnormalities in patients with UCLP. 7 Therefore, it has been unclear whether expansion of nasal Objectives: Rapid maxillary expansion (RME) improves nasal airway ventilation in non-cleft palate children. Children with unilateral cleft lip and palate (UCLP) may have nasal obstruction and experience an increased risk of obstructive sleep apnoea. The effect of RME in UCLP children is unclear. This retrospective study evaluated RMEinduced changes in ventilation parameters in children with UCLP using computational fluid dynamics. Setting and Sample Population: Nineteen patients (10 boys, mean age 10.7 years)who required RME had cone-beam computed tomography images taken before and after RME. Twenty control participants (11 boys, mean age 11.1 years) received regular orthodontic treatment.Methods: Nasal airway ventilation parameters (air pressure, air velocity and airflow rate) were analysed via computational fluid dynamics, and nasal cross-sectional area (CSA) was measured.Results: Maximum pressure, velocity and nasal resistance were significantly reduced by RME in the UCLP group. Air flow rate and CSA on the cleft side significantly were increased by RME in the UCLP group. Conclusions:In children with UCLP, increasing the quantity of airflow and CSA on the cleft side by RME substantially improved nasal ventilation. K E Y W O R D S children, computational fluid dynamics, nasal airway, rapid maxillary expansion, unilateral cleft lip and palate 202 | IWASAKI et Al.width diameter and dentition improves nasal airway ventilation.Recently, computational fluid dynamics (CFD) has been used for evaluation of airway ventilation. 8 Regardless of upper airway shape, CFD reproduces the flow of air and can evaluate air current in the nasal airway alone. Therefore, we speculated that CFD evaluation may be more precise in the evaluation of complicated nasal airways in children with UCLP.The current study investigated improvements in nasal airway ventilation associated with RME in patients with UCLP via CFD in which nasal airway ventilation could be evaluated without being influenced by the complexity of nasal airway shape.

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Section: Discussionmentioning

confidence: 98%

“…However, improvements in nasal airway ventilation associated with RME in children with UCLP are unclear, particularly in cases involving nasal airway ventilation obstruction . In studies investigating RME in patients with UCLP, the volume and cross‐sectional area of the nasal airway reportedly increase.…”

Section: Introductionmentioning

confidence: 99%

Rapid maxillary expansion effects of nasal airway in children with cleft lip and palate using computational fluid dynamics

Iwasaki

Yanagisawa‐Minami

Suga

et al. 2019

Orthod Craniofacial Res

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“…Its effects in increasing the airway volume has been tackled in many studies. 8,10,12 The fan expander has been favored by many orthodontists in treating BCLP patients due to the considerable amount of anterior expansion it has on the dental arch, which is much needed in anteriorly collapsed arches, a common finding in BCLP patients. However, the hyrax expander has almost always been the golden standard of care in constricted maxillae, having excellent results in expanding the arch both posteriorly as well as anteriorly.…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal Airway Changes after Rapid Maxillary Expansion in Children with Bilateral left Lip and Palate

Abdelrahman

El-Badawy

2020

Egyptian Dental Journal

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“…Usually this occurs in preparation for the alveolar cleft grafting procedure during the mixed dentition/early permanent dentition stages. The effect of the RME on the nasal chambers were raised with a considerable amount of debate whether the change produced by RME increases the nasal chambers width [9][10][11] , which inevitably will enhance nasal breathing in these individuals, otherwise suffering nasal respiration restriction. Our study's purpose was to assess whether the type of expander would affect the anterior and posterior nasal widths after expanding the maxillary dental arch.…”

Section: Discussionmentioning

confidence: 99%

Nasal Chamber Changes Following Rapid Maxillary Expansion in Children with Bilateral Cleft Lip and Palate

Abdelrahman

Mostafa

2020

Egyptian Dental Journal

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Purpose:The aim was to study the skeletal effect of rapid palatal expansion (RPE) on the anterior and posterior nasal width in a sample of Egyptian children (age range 9.4-14.3 years, mean 11.16 years) with bilateral cleft lip and palate (BCLP).Methods: Twenty Egyptian children with complete BCLP exhibiting maxillary transverse deficiency were divided randomly into; Group 1 received a fixed fan expander and Group 2 a hyrax expander. Cone-beam computed tomography (CBCT) images were taken before T1 and 3 months after expansion T2, just before the alveolar cleft grafting (ACG) surgical procedure. Linear and angular measurements were assessed to measure the degree of change on the anterior and posterior nasal chamber widths, dentition, and dental arch.Results: Repeated measure ANOVA with a between variable analysis was used to examine the effect of the two expanders on the dental arch and anterior nasal width as well as posterior nasal width. Statistically significant increase in dentoalveolar measurements were found in each group, nasal widths showed no statistically significant differences before and after expansion.

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Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography study

Abstract: Only the Hyrax and inverted mini-hyrax on the molar expanders effectively increased the nasal passage volume, and none of the expanders evaluated in this study modified the oropharyngeal airway.

Cited by 20 publications

References 22 publications

Rapid maxillary expansion effects of nasal airway in children with cleft lip and palate using computational fluid dynamics

Rapid maxillary expansion effects of nasal airway in children with cleft lip and palate using computational fluid dynamics

Oropharyngeal Airway Changes after Rapid Maxillary Expansion in Children with Bilateral left Lip and Palate

Nasal Chamber Changes Following Rapid Maxillary Expansion in Children with Bilateral Cleft Lip and Palate

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