Abstract
IntroductionThe aim of this study was to evaluate three dimensionally the effect of the combined maxillary expansion and protraction treatment on oropharyngeal airway in children with non-syndromic cleft palate with or without cleft lip (CP/L).MethodsCBCT data of 18 preadolescent individuals (ages, 8.4 ± 1.7 years) with CP/L, who underwent Phase I orthodontic maxillary expansion with protraction, were compared before and after treatment. The average length of treatment was 24.1± 7.6 months. The airway volume and minimal cross-sectional area (MCA) were determined using 3DMD Vultus imaging software with cross-sectional areas calculated for each 2-mm over the entire length of the airway. A control group of 8 preadolescent individuals (ages, 8.7 ± 2.6 years) with CP/L was used for comparison.ResultsThere was a statistically significant increase in pharyngeal airway volume after phase I orthodontic treatment in both groups, however, there was no statistically significant change in minimal cross-sectional area in neither study nor control group.ConclusionThe findings showed that maxillary expansion and protraction did not have a significant effect on increasing oropharyngeal volume and MCA in patients with CP/L.
Highlights
The aim of this study was to evaluate three dimensionally the effect of the combined maxillary expansion and protraction treatment on oropharyngeal airway in children with non-syndromic cleft palate with or without cleft lip (CP/L)
The findings showed that maxillary expansion and protraction did not have a significant effect on increasing oropharyngeal volume and minimal cross sectional area (MCA) in patients with CP/L
Children with CP/L are known to have airway complications [3]. It has been shown through three-dimensional analysis that there is a smaller oropharyngeal height and airway volume in CP/L individuals compared with non-cleft individuals [3]
Summary
The aim of this study was to evaluate three dimensionally the effect of the combined maxillary expansion and protraction treatment on oropharyngeal airway in children with non-syndromic cleft palate with or without cleft lip (CP/L). Another study utilizing CBCT data looked at the oropharyngeal volume in unilateral cleft lip and palate (UCLP) individuals and showed rapid maxillary expansion did not significantly increase oropharyngeal volume [12]. In order to correct this developing malocclusion, maxillary expansion and protraction is commonly used during phase 1 orthodontics for such individuals in preparation for alveolar bone grafting. It is not clear if maxillary expansion results in an increase in the volume of the oropharyngeal area. Fu et al looked at the effects of maxillary protraction from reverse headgear and found that the pharyngeal airway volume was significantly enlarged after treatment in individuals with clefts who had protraction compared to those who did not have maxillary protraction [15]
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