Abstract
IntroductionTransverse maxillary deficiency is a high prevalent growth disorder within the adult population that may lead to serious health issues, such as detrimental malocclusions and higher risk of developing obstructive sleep apnea (OSA). Mini-implant assisted rapid palatal expansion (MARPE), as it expands the mid-face and augment the nasal and oral cavities dimensions, may reduce the airflow resistance and thus play an important role on OSA therapy in some patients. The main objective of the present trial is to assess MARPE effects on the sleep and quality of life of non-obese adult OSA patients with transverse maxillary deficiency.MethodsA total of 32 participants were divided into intervention and control groups. They underwent physical evaluation, Epworth Sleepiness Scale (EES) and Quebec Sleep Questionnaire (QSQ), cone-beam computed tomography (CBCT) and home sleep testing (HST) for OSA before MARPE (T1) and 6 months after the intervention (T2).ResultsQuestionnaires EES (daytime sleepiness) and QSQ (OSA-related quality of life) presented significant statistical differences between the groups. We also found clinical and statistical (p < 0.01) differences between the groups regarding the apnea/hypopnea index (AHI), as well as others HST parameters (mean oxygen saturation and snoring duration).ConclusionIn our sample, MARPE (without any auxiliary osteotomy) showed a good success rate (85%) and promoted important occlusal and respiratory benefits. We observed important daytime sleepiness and OSA-related quality of life improvement, as well as the AHI (65.3%), oxygen saturation and snoring duration.
Highlights
Transverse maxillary deficiency is a high prevalent growth disorder within the adult population that may lead to serious health issues, such as detrimental malocclusions and higher risk of developing obstructive sleep apnea (OSA)
The objective of our study is to assess the clinical outcomes of adult non-obese OSA patients who underwent Mini-implant assisted rapid palatal expansion (MARPE), when compared to a control group, using home sleep testing and OSA-related quality of life questionnaires
No significant weight or neck circumference variations were observed in both groups
Summary
Transverse maxillary deficiency is a high prevalent growth disorder within the adult population that may lead to serious health issues, such as detrimental malocclusions and higher risk of developing obstructive sleep apnea (OSA). The American College of Physicians and the Canadian Sleep Society have encouraged HST for patients without medical comorbidities (e.g., pulmonary diseases, neurological disorders, and congestive heart failure) and concomitant sleep disorders (e.g., periodic limb movement and central apnea) [7]. Most HST’s rely on type III monitors and include several important channels for an obstructive sleep apnea testing. These devices have been extensively tested and validated through in-lab polysomnography (PSG) comparison studies, exhibiting sufficient sensitivity and specificity [8,9,10]
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