Abstract
Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, 14.2 ± 1.3 years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, 13.8 ± 1.5 years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group (mean = 1.3 mm) compared to the control group (mean = 0.5 mm), P = 0.016. However, there was no significant difference in the lower pharyngeal airway measurement between the RME group (mean = 0.2) and the control group (mean = 0.4), P = 0.30. There was no significant difference with respect to mode of breathing between the two groups (P = 0.79). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.
Highlights
Maxillary constriction is associated with several problems that include cross bite, occlusal disharmony, esthetics and functional problems such as narrowing of the pharyngeal airway [1, 2]
Maxillary constriction might play a role in the pathophysiology of obstructive sleep apnea (OSA) because maxillary constriction is associated with low tongue posture that could result in oropharynx airway narrowing, which is a risk factor for OSA [1, 2, 28]
The expansion group had a significant increase in the upper pharyngeal airway, while there was no difference between the two groups in regards to the lower pharyngeal airway
Summary
Maxillary constriction is associated with several problems that include cross bite (dental and/or skeletal), occlusal disharmony, esthetics and functional problems such as narrowing of the pharyngeal airway [1, 2]. Several studies have shown that maxillary constriction may play a role in the etiology of obstructive sleep apnea (OSA) [3,4,5]. OSA is a condition characterized by the episodic cessation of breathing during sleep. An examination of the causes of apnea has produced several classifications for this condition. Apnea secondary to sleep-induced obstruction of the upper airway and combined with simultaneous respiratory efforts is the most common type and has been classified as obstructive sleep apnea syndrome (OSAS). Impaired sleep quality leads to excessive daytime sleepiness, deterioration of memory and judgment, altered personality, and reduced concentration [6, 7]
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