Abstract
Rapid maxillary expansion (RME) is considered an effective treatment in the management of sleep-disordered breathing (SDB) and malocclusions in pediatric patients, not only because it is able to correct the transverse maxillary deficiency, but it also widens the floor of the nasal cavities, leading to a drastic and immediate reduction in air resistance and facilitating a normal nasal breathing pattern. The aim of this study was to evaluate cephalometric changes in the upper airway’s dimensions and facial morphology in pediatric SDB patients treated with RME, comparing data with a no-SDB group treated with RME for malocclusion. In this retrospective study, pre-treatment and post-treatment cephalometric variables were measured on lateral skull radiographs from 20 SDB pediatric patients (nine males and 11 females) aged 6 to 9 years (mean age 7.61 ± 0.6), treated with a rapid maxillary expander, and 20 control patients without SDB (nine males and 11 females) aged 6 to 11 years (mean age 8.4 ± 0.5). In both groups, there were statistically significant changes in the variables indicating the airway’s dimensions and mandibular sagittal position in relation to the cranial base, with a skeletal class II correction in SDB children. Rapid maxillary expansion is associated with an increase in upper-airway dimensions in SDB children, as well as in control healthy subjects, with a possible correction of class II relationship.
Highlights
Sleep-disordered breathing (SDB) indicates breathing difficulties during sleep time; it is a disorder characterized by prolonged increased upper-airway resistance and partial or complete upper-airway obstruction, which compromise the pulmonary ventilation or the sleep quality [1]
Pre-treatment and post-treatment cephalometric variables were measured on lateral skull radiographs from 20 sleep-disordered breathing (SDB) pediatric patients with mixed dentition, aged between 6 and 9 years, treated with rapid maxillary expander
At the end of the treatment, all patients had an improvement in clinical parameters relating to nocturnal breathing (Table 2)
Summary
Sleep-disordered breathing (SDB) indicates breathing difficulties during sleep time; it is a disorder characterized by prolonged increased upper-airway resistance and partial or complete upper-airway obstruction, which compromise the pulmonary ventilation or the sleep quality [1]. Children with adenotonsillar hypertrophy are usually treated with adenotonsillectomy, but the surgery itself may cause a narrower epipharyngeal air space and a more poorly developed maxilla, which may predispose children to sleep-disordered breathing, with a continuum of severity, varying from snoring to obstructive sleep apnea [12]. For this reason, rapid maxillary expansion (RME) is considered a treatment option as part of an orthodontic procedure for managing this respiratory disorder [13–16], since RME is a painless treatment [17] that can simultaneously correct transverse maxillary deficiency and widen the floor of the nasal cavities. Cephalometric variations of overbite and overjet can be observed
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