Abstract
BackgroundThe aim of this study is to investigate the pharyngeal airway space changes in patients treated with rapid palatal expansion (RPE) and Herbst appliance with or without skeletal anchorage.MethodsA 40-patient study group treated with the Herbst RME combination was included; moreover, a comparison between two subgroups based on whether miniscrews were used was evaluated. A subgroup 1 included 20 patients who were treated with RPE and an acrylic splint Herbst with miniscrews, and subgroup 2 included 20 patients who were treated with RPE and an acrylic splint Herbst. A cephalometric analysis was performed before (T1) and after (T2) treatment. The skeletal parameters of the sagittal occlusion analysis of Pancherz were utilized together with some extra measurements to evaluate the airways.ResultsAn increased nasopharyngeal airway space was observed in group 1 (p < 0.05) from T1 to T2. Furthermore, the increase in nasopharyngeal airway space was significantly higher in subgroup 1 (p < 0.05) in comparison to the subgroup 2. Oropharyngeal (OA) and laryngopharyngeal (LA) dimensions were significantly increased in the subgroup 1 at the end of the treatment. In the subgroup 1, a significant decrease in SNA, a significant increase in SNB, and a significant decrease in ANB were observed from T1 to T2. In the subgroup 2, the treatment resulted in a significant decrease in ANB. In both groups, Pogonion increased significantly from T1 to T2.ConclusionsThe results suggest that the RPE and the Herbst appliance allow a slight improvement of the sagittal dimensions of the airways. The oropharyngeal dimension increased significantly more in the skeletal anchorage group.
Highlights
The aim of this study is to investigate the pharyngeal airway space changes in patients treated with rapid palatal expansion (RPE) and Herbst appliance with or without skeletal anchorage
As regards the upper airways, it was observed a slight increase of the pharyngeal space after rapid palatal expansion therapy; this minimal change is probably due to growth, as in Linder-Aronsson and Leighton’s longitudinal study in 1983, AD2 increased 2.3 mm between the age of 12 and 15 [9]
The patients were divided into two subgroups: subgroup 1 included 20 patients (11 females, 9 males, mean age 12.5 ± 1.7 years), who were consecutively treated with an acrylic splint Herbst appliance with miniscrews, and 20 selected patients (10 females, 10 males, mean age 12.1 ± 1.3 years), who were similar in age and gender to the subgroup 1 and were treated with an acrylic splint Herbst appliance without miniscrews
Summary
The aim of this study is to investigate the pharyngeal airway space changes in patients treated with rapid palatal expansion (RPE) and Herbst appliance with or without skeletal anchorage. It was previously reported that retrognathia is Alterations of the airway dimensions can influence the respiration of the subject during the growth phase [6]. It has been reported that a reduction in the blank space of superior airways represents a risk factor, even for obstructive sleep apnea syndrome [7]. As regards the upper airways (nasopharyngeal airway space), it was observed a slight increase of the pharyngeal space after rapid palatal expansion therapy; this minimal change is probably due to growth, as in Linder-Aronsson and Leighton’s longitudinal study in 1983, AD2 increased 2.3 mm between the age of 12 and 15 [9]
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