Effects Of Rapid Maxillary Expansion Research Articles

Effects of rapid maxillary expansion on upper airway parameters in OSA children with maxillary restriction: A CBCT study.

Rapid maxillary expansion (RME) has been proposed as an effective treatment for pediatric obstructive sleep apnea (OSA) and maxillary restriction in children. This study aimed to evaluate the effect of RME appliances on the nasomaxillary complex dimensions in children with OSA and maxillary constriction. This prospective longitudinal study included 34 children aged 8-12 years with maxillary restriction and OSA confirmed by polysomnography who had completed RME therapy. The nasomaxillary complex is segmented into the nasal cavity, maxillary sinuses, and nasopharynx. The effect of RME on nasomaxillary complex dimensions was assessed pre and posttreatment using cone-beam computed tomography, analysis, while a second standard overnight polysomnography (PSG) was performed to assess changes in respiratory parameters. Significant improvements were observed, including inferior maxillary dislocation (S-S1 distance and N-ANS), increased anterior and posterior facial height, and a 5.43 events/h reduction in Apnea-Hypopnea Index (p < .001). The nasal cavity volume increased by 2439 (±584) mm3 (p < .001), nasopharynx size increased by 883 (±479) mm3 (p = .008), mid cross-sectional area increased by 31.74 (±14.50) mm2 (p < .001), and the distance between the right and left maxillary sinuses increased by 8.37 (±3.67) mm (p < .001) all exhibited positive changes, with some insignificant variations in volume change (p = .254). RME treatment was found to be effective in improving nasal cavity and nasopharyngeal dimensions, leading to improved respiratory parameters in children with OSA and maxillary constriction. While these results are promising, considerations about the potential long-term benefits of RME on future growth are important. The study provides valuable insights into the efficacy of RME as a treatment option for this pediatric population.

Effects of Rapid Palate Expansion Treatment in Growing Oral Respiratory Patients: Functional Assessment of the Upper Airway Using Active Anterior Rhinomanometry

This retrospective study aims to further investigate the effects of rapid maxillary expansion (RME) treatment on respiratory function in growing patients with contracted upper airways, by assessing nasal resistance using active anterior rhinomanometry (AAR). Methods: At T0 (pre-RME), 122 orthodontic patients aged 5 to 12 years, exhibiting oral breathing and/or snoring along with maxillary contraction, underwent AAR with a mask using the ATMOS Rhino 31 rhinomanometer. Additionally, the SRDB or PSQ-SRDB Questionnaire was utilized to validate the orthodontic history of obstructive sleep apnea syndrome (OSAS). If AAR results at T0 were clinically significant, they were repeated at T1, corresponding to a period of three months after screw fixation, to evaluate changes in nasal resistance values between pre- and post-treatment. Results: The study group comprised 42 oral respiratory patients with a mean age of 7.71 years, suspected of pediatric OSAS. Although the questionnaires did not yield statistically significant results, the therapy induced an overall reduction in airflow resistance values from both nostrils (−24.63% in the right nostril; −26.65% in the left nostril). Conclusions: This study demonstrates the beneficial effects of orthodontic treatment with RME on nasal function in terms of airflow resistance in cases of maxillary contraction.

Effects of Maxillary Expansion on the Ear - A Review

Rapid maxillary expansion is a commonly used treatment modality for the correction of maxillary transverse deficiency in cleft and non-cleft patients. Additional beneficial effects of rapid maxillry expansion includes improvement in nasal stenosis, abnormal breathing pattern and conductive hearing loss. The improvements in the hearing have been linked to the improved function of the two soft palatal muscles, the tensor veli palatini and the levator veli palatini muscles. This study aims to explore the different studies which have evaluated the effects of rapid maxillary expansion on hearing in cleft and non cleft patients.

Medium-term effects of rapid maxillary expansion on nasal cavity and pharyngeal airway volumes considering age as a factor: A retrospective study

ObjectivesThe medium-term effects of rapid maxillary expansion (RME) on nasal cavity (NC) and upper airway (UA) dimensions based on chronological age are still unclear. This retrospective study evaluated the medium-term changes occurring in the NC and pharyngeal airways (PA) after RME in two distinct age-based cohorts of patients. MethodsThis retrospective study included 48 subjects who underwent RME grouped in two cohorts: a 6–9-year-old group (EEG group: early expansion group - 25 subjects) and an 11–14-year-old group (LEG group: late expansion group - 23 subjects). NC and PA volumes were analyzed from CBCT imaging segmentation before RME (T0) and twelve months after RME (T1). The amount of maxillary expansion (PW) and minimal cross-sectional area (CSmin) were also considered. ResultsAll PAs’ volumetric sub-regions, CSmin and PW showed a significant volumetric increment (p < 0.05). Inter-group comparisons showed significant differences (p < 0.05) for nasopharynx and CSmin parameters (p < 0.05), while no significant changes were recorded for the other UA's sub-regions and PW (p > 0.05). According to a deviation analysis, part of the UA increase (more marked for the nasopharynx area) may have occurred due to reduced adenotonsillar tissues, which were larger in the EEG group. ConclusionsTwelve months after treatment, clinicians should not expect changes in the UAs dimensions to be solely related to treatment effects of RME; instead, normal craniofacial growth changes and spontaneous regression of the adenotonsillar tissue could represent the most significant factors influencing UAs changes. Clinical SignificanceFrom the clinical perspective, the results of the present study encourage caution when considering the therapeutic effects of RME on airways dimensions.

Awareness and attitude among general dentists and orthodontists toward obstructive sleep apnea in children.

This study aimed to investigate Italian dentists' knowledge of and attitudes toward obstructive sleep apnea (OSA) in children. An anonymous questionnaire was prepared using Google Forms and sent to dentists in Italy through private social platforms. The first part of the questionnaire contained basic demographic data questions, and the second part included items about pediatric OSA. A total of 125 responses were collected within 1 month. The interviews revealed gaps in undergraduate and post-graduate training on OSA, and consequently, low self-evaluation of knowledge and self-confidence in managing young patients with OSA. Dentists showed unfavorable attitudes and poor knowledge of the general findings, risk factors, and consequences of pediatric OSA but demonstrated good knowledge of the beneficial effects of rapid maxillary expansion. Orthodontists showed a more favorable attitude and better recognition of the craniofacial features associated with OSA. In addition, a comparison was made between dentists who had graduated more than 5 years ago and new graduates, and differences were found in undergraduate education, which was better for new graduates, and a small number of questions were better answered by experienced dentists. This study showed a lack of knowledge about pediatric OSA and its management among Italian dentists, revealing the need to update the dentistry curriculum and organize educational interventions.

The effects of rapid maxillary expansion on persistent pediatric snoring post-tonsillectomy

The effects of rapid maxillary expansion on persistent pediatric snoring post-tonsillectomy

Skeletal and Dentoalveolar Changes in Growing Patients Treated with Rapid Maxillary Expansion Measured in 3D Cone-Beam Computed Tomography.

The skeletal and dental effects of rapid maxillary expansion (RME) have been extensively studied, but high-quality research is still needed to determine the three-dimensional (3D) effects of RME. The aim of this study was to compare skeletal and dentoalveolar parameters through cone-beam computed tomography (CBCT) pre- (T1) and post-treatment (T2) with respect to RME. Twenty growing patients (mean age 10.7 years) were treated with a Hyrax-type expander. A 3D CBCT was performed at T1 and T2, measuring nasal width, maxillary width, palatal height, maxillary arch perimeter, angulation of the upper first molar, and intermolar width. The mean palatal suture opening was 2.85 ± 0.62 mm (p < 0.0001). Nasal width increased 1.28 ± 0.64 mm and maxillary width 2.79 ± 1.48 mm (p < 0.0001). In contrast, palatal height was reduced 0.65 ± 0.64 mm (p < 0.0001). Regarding arch perimeter, the radicular perimeter increased 2.89 ± 1.80 mm, while the coronal perimeter increased 3.42 ± 2.09 mm (p < 0.0001). Molar angulation increased 5.62 ± 3.20° for the right molar and 4.74 ± 2.22° for the left molar (p < 0.0001). Intermolar width increased 5.21 ± 1.55 mm (p < 0.0001). Treatment with Hyrax produced a significant opening in the mean palatal suture. Also, a significant increase in nasal width, maxillary width, arch perimeter, molar angulation, and intermolar width, and a decrease in palatal height, were observed.

Effect of rapid maxillary expansion on masticatory and swallowing functions in children with posterior crossbite

ObjectiveInvestigate the influence of posterior crossbite on masticatory and swallowing functions by videofluoroscopy examination and to analyze the effects of Rapid Maxillary Expansion (RME) on the same functions. MethodsA prospective longitudinal study was conducted on 32 children, 21 of them with posterior crossbite (10 girls and 11 boys, mean age 9.2 years, study group) and 11 children with no occlusal changes (6 girls and 5 boys, mean age 9.3 years, control group). The children were evaluated by an orthodontist for diagnosis, group characterization and occlusal treatment, by the otorhinolaryngology team for the assessment of respiratory symptoms, and by a speech therapist for videofluoroscopic evaluation of masticatory and swallowing parameters. The children with posterior crossbite were treated orthodontic ally using the Haas disjunctor for approximately six months and re-evaluated 5-months after removal of the appliance. Data were analyzed statistically by the Studentt-test for independent samples for comparison of the crossbite and control groups before and after treatment. ResultsThere was no significant difference in oral preparatory and oral transit times, nor in cycles and masticatory frequency, between the pre and post orthodontic treatment groups and the control group. ConclusionRapid maxillary expansion did not influence the masticatory and swallowing variables studied by videofluoroscopy. However, the data require caution in interpretation.

Rapid maxillary expansion and nasal patency in mouth breathing children with maxillary atresia due to or not due to allergic rhinitis.

To evaluate the effects of rapid maxillary expansion (RME) on nasal patency in mouth breathing (MB) children with maxillary atresia due to or not due to allergic rhinitis (AR) associated with asthma. Fifty-three MB children/adolescents (aged 7-14 years) with mixed or permanent dentition and maxillary atresia participated, with or without unilateral or bilateral crossbite. They formed the groups: RAD (AR + asthma; clinical treatment, RME); RAC (AR + asthma; clinical treatment, no RME); and D (mouth breathers; RME only). RAD and RAC patients received topical nasal corticosteroid and/or systemic H1 antihistamine (continuous use) and environmental exposure control. All were evaluated before RME (T1) and 6 months after (T2) with the CARATkids score, acoustic rhinometry, and nasal cavity computed tomography (CT). Patients RAD and D underwent RME (Hyrax® orthopedic appliance). A significant reduction in the CARATkids score occurred in the RAD (-4.06; p < 0.05), similarly when patient and parent/guardian scores were evaluated (-3.28 and -3.16, respectively). Acoustic rhinometry (V5) showed increased nasal volume in all groups, significantly higher in RAD patients than in RAC and D (0.99 × 0.71 × 0.69 cm3, respectively). CT of the nasal cavity documented increased volume in all three groups, with no significant differences between them. In MB patients with AR, asthma, and maxillary atresia, RME increased nasal cavity volume and improved respiratory symptoms. However, it should not be used as the only treatment for managing patients with respiratory allergies.

Effects of rapid maxillary expansion on sleep disturbance scale for children: A longitudinal CASE-series study.

To evaluate the effects of rapid maxillary expansion (RME) on Sleep Disturbance Scale for Children (SDSC) with maxillary atresia. The sample consisted of 27 paediatric patients evaluated through a Brazilian version of the SDSC, answered by their guardians at the following experimental time points: T0 (before installing the Hyrax expander), T1 (on the day of expander stabilization), T2 (3 months after expander stabilization), T3 (immediately after expander removal, following 6 months of retention), and T4 (3 months post-retention). Multilevel Poisson analysis adjusted for repeated measures was performed to compare outcomes across the assessment time points. The mean age of patients was 9.1 years (SD = 1.46). The total SDSC scores decreased and were statistically significant from T2 onwards (P < .01), with a decrease of 24% at T4 compared with T1 (IRR 0.76; 95% CI 0.69-0.84). The mean scores at T4 were already lower than the cutoff point for risk of sleep disorders. Regarding the specific domains, there was a significant reduction in sleep breathing disorders, sleep-wake transition disorders, and disorders of excessive somnolence as of T2 (P < .01), T3 (P < .05) and T4 (P < .05), respectively. RME in children with maxillary atresia had a positive effect on the reduction of total SDSC scores after 3 months of expander stabilization, sustained over 6 and 9 months and significant reduction in sleep breathing disorders domain, sleep-wake transition disorders domain, and disorders of excessive somnolence domain over time points.

CAMBIOS EN LA VÍA AEREA SUPERIOR POSTERIOR A EXPANSIÓN RAPIDA DEL MAXILAR EN NIÑOS DE 12 AÑOS

Rapid maxillary expansion is often considered the treatment of choice for the correction of maxillary constriction. Several studies highlight the effect of rapid maxillary expansion in increasing nasal length and volume. The aim of this study is quantifying the volumetric changes of the upper airway, the maximum restricted area of the upper airway and the nostrils area, after the intervention of a rapid maxillary expansion using bimaxillary CBCT. A retrospective study was carried out, in which 14 patients of 12 year old with a diagnosis of unilateral or bilateral crossbite and skeletal maxillary constriction were selected. The treatment was carried out with a Mcnamara-type rapid expansion device and 8 mm of disjunction was planned. An initial bimaxillary CBCT was requested and another 15 days after treatment. Measurements were made at the maxillary level, upper airway and the maximum restricted area and the cross section of the nostril area, using 3D measuring softwares. It was obtained that, for every 1 mm of planned disjunction, 0.65 mm of maxillary disjunction is achieved, an upper airway gain of 0.7 cm3, the maximum restricted area gain of the upper airway of 9 mm2 and a gain in the nostrils area of 7.4 mm2 on average. In conclusion rapid maxillary expansion generates a significant increase in the volume of the upper airway and its narrower area

Rapid maxillary expansion treatment increases mid-facial depth in early mixed dentition.

To evaluate the effects of rapid maxillary expansion (RME) on mid-facial depth in early mixed dentition and to investigate the relationship between change in mid-facial depth and maxillary sinus and nasal cavity. A total of 35 patients with mixed dentition treated with a Haas expander were included in this retrospective study. All patients underwent a cone-beam computed tomography scan before and after rapid maxillary expansion. The Wilcoxon signed-rank test was performed to evaluate the changes in maxillary width, facial depth, maxillary sinus, and nasal cavity volume before and after expansion. Multiple linear regression analysis was applied to evaluate the correlations among them. The hard and soft tissue facial depth in the middle third increased significantly (P < 0.001). The gain on the outer sagittal plane (1.04-1.52 mm) was slightly bigger than that on the inner sagittal plane (0.91-1.30 mm). Maxillary width and nasal cavity width increased 3.42 ± 0.93 mm (P < 0.001) and 2.25 ± 0.77 mm (P < 0.001), respectively, after treatment. A gain was also achieved in both nasal cavity volume (2,236.15 mm3, P < 0.001) and maxillary sinus volume (1,227.33 mm3, P < 0.001). Multiple linear regression analysis showed that with the increase in maxillary sinus volume, the facial depth increased as well (B = 0.455-0.683, P < 0.05). Also, statistically significant correlations were found between nasal width and nasal cavity volume (B = 0.384, P < 0.05). The depth of the middle third face increased significantly. The facial depth increase was related to the enlargement of maxillary sinus volume, while the nasal cavity volume gain was related to the nasal width increase. This indicated that RME might enhance the fullness of the mid-face and facilitate the patency of nose breathing.

Effects of Rapid Maxillary Expansion on Upper Airway Volume in Growing Children: A Three-Dimensional Cone-Beam Computed Tomography Study.

Background: Rapid maxillary expansion (RME) is a common orthodontic procedure that widens the maxillary arch to treat moderate to mild overcrowding and transverse skeletal and dental abnormalities. Orthodontic equipment applies lateral tension on posterior maxilla teeth or palate mucosa to the mid-palatal suture. The maxilla may grow transversely when force is applied at right angles to the mid-palatal suture, which is usually inactive in children and adolescents. This study used cone-beam computed tomography (CBCT) and an authorized upper respiratory airway volume measurement approach to compare RME cohort pharyngeal airway volume changes to healthy controls. Materials and Methods: This retrospective analysis included 52 RME patients and 52 healthy controls. The RME category's expansion regimen entailed twisting the screw of expansion on a tooth-attached Hyrax-type expansion equipment by 0.25 mm daily for at least 14 days. After six months, a few RME participants used fixed orthodontic gear. The comparison group used fixed orthodontic appliances for minor malocclusions without extractions (without RME). CBCT scans from 1021 orthodontic patients who visited a dental hospital between 2012 and 2022 were examined. The registry comprised only anonymized photographs. Volume, minimum cross-sectional area (MCA), molar width, and inter-molar width were measured before and after therapy. Results: The control group had 12227.12 mm3 at T0 and 15805.54 mm3 at T1. The control group's T0-T1 volume difference was statistically significant (p = 0.007). The RME group has 12884.84 mm3 at T0 and 17471.08mm3 at T1. The RME group had a significant volume difference at T0 and T1 (p = 0.002). The volume RME effect was ±1011.92and statistically insignificant. (p > 0.05). MCA in the control group was 126.04 mm2 at T0 and 170.61 mm2at T1. MCA at T0 and T1 in the control group was statistically significant (p = 0.041). RME group MCA was 126.53 mm3 at T0 and 164.69 mm2 at T1. The RME group had a significant volume difference at T0 and T1 (p = 0.002). The MCA, RME effect was 5.92 and statistically insignificant (p > 0.05). Both the control and RME groups had statistically significant volume and MCA differences at T0 and T1. However, the intergroup analysis showed no significant differences across the groups. Conclusion: Tooth-borne RME does not affect upper airway or MCA volume in children compared to controls. Upper airway changes were better with younger skeletal ages before treatment. The findings may aid RME for young children.

Effect of rapid maxillary expander with posterior bite blocks in hyperdivergent patients with adenoid hypertrophy- A cephalometric study

To analyze the effect of Rapid Maxillary Expansion (RME) with posterior bite blocks on craniofacial structures in hyperdivergent patients with adenoid hypertrophy and to compare them with control group. 32 patients of adenoid hypertrophy (mean age 11.6 yrs, range 8-12 years) with a transverse discrepancy were selected and divided into two groups in a random way - Group A: (n=16) hyrax RME with posterior bite block group, Group B: (n=16) control group. Group A- Lateral and Posteroanterior cephalograms were recorded pretreatment (T0), postexpansion (T1), and after 9 months retention (T2). Group B- Lateral and Posteroanterior cephalograms were recorded pretreatment (T0), and after 9 months (T2) concurrent with Group A. Cephalometric measurements in sagittal, vertical and transverse dimensions were taken and comparison was made using Paired and Unpaired t-test with p &amp;#60; 0.05 as statistically significant. Group A underwent insignificant increase in SN-MP angle whereas it increased significantly in Group B. The lower facial height and jarabak’s ratio decreased significantly. All transverse parameters increased significantly with maximum increase in intermolar width when compared with Group B. Significant increase in the transverse dimensions of mid face occurs with RME thus increasing the upper airway patency and effective control of the vertical growth pattern, typical of adenoid hypertrophy, was seen in the treatment group when compared with the control group.

The effects of rapid maxillary expansion on persistent pediatric snoring post-tonsillectomy.

To investigate the short-term effects of rapid maxillary expansion (RME) on the quality of life of children who had persistent snoring post-adenotonsillectomy (AT). The study included childrenwith maxillary constriction aged 5 to 12years, two or more years after AT whose parents/guardians reported that they still snored ≥ 5 nights per week. We enrolled children with sleep-disordered breathing, including children with primary snoring and children with obstructive sleep apnea(OSA). All patients underwent laryngeal nasofibroscopy and complete polysomnography. Quality of Life (QOL) Questionnaire (OSA-18), the Pediatric Sleep Questionnaire (PSQ), Conners Abbreviated Scale (CAS), and the Epworth Sleepiness Scale (ESS) were administered before and after RME. Of 24 children enrolled, 13 had primary snoring and 11 had OSA.Overall OSA-18 scores were reduced in both groups (intragroup difference, p < 0.001). The PSQ total score, CAS, and ESS were significantly reduced in both groups (p < 0.001) In the evaluation of snoring, there was a reduction due to the treatment effect in both groups (p < 0.001). Daytime sleepinessand attention deficit hyperactivity disorders were also positively affected in both groups. Our study demonstrated the potential benefit of RME in treating children with persistent snoring and transverse maxillary deficiency (TMD). RME can improve snoring and the QOL of children with refractory SDB after AT. ClinicalTrials.gov Identifier: RBR-463byn.

Age-dependent interactions of maxillary sutures during RME and their effects on palatal morphology : CBCT and dental cast analysis.

PurposeThe effects of rapid maxillary expansion (RME) on the transverse palatine and midfacial sutures have been extensively scrutinized. Unlike the dentition stage, age-dependency was not yet regarded when investigating morphological changes of the tooth-bearing palate. Therefore, the first aim of the present study was to analyse age-dependent sutural and morphological changes of the palate in selected patients by cone-beam computed tomography (CBCT) and dental cast analysis. Secondly, age-dependent effects of RME on width, height, and depth of the palate in the region of the maxillary palatine processes were investigated by a comprehensive dental cast study, so that the combination of results could be used to provide a biomechanical explanation of the occurring changes.MethodsCBCT datasets of 9 patients (between 7.3 and 13.8 years) were measured around the median palatal suture and compared with the results of an individualised dental cast analysis. In addition, possible effects on other maxillary sutures were investigated. In the dental cast study, changes after RME in the tooth-bearing palate were analysed three-dimensionally in 60 children and adolescents. It was possible to divide those into three equally sized, age-dependant groups (PG1: < 10 years, n = 20; PG2: ≥ 10 < 12 years, n = 20; PG3: ≥ 12 years, n = 20).ResultsThe CBCT analysis reveals age-related differences in sutural responses. The opening width of the median palatine suture decreases cranially (frontal) and dorsally (horizontal). The opening mode thus changes from parallel to triangular in both planes. The transverse palatine suture completely opens in younger patients only (PG1 and PG2). The width increases are always significant in all patients. While in PG1 the width increase is greater posteriorly than anteriorly, this is always reversed in PG2 and PG3. The palatal height always increases significantly anteriorly, but posteriorly only in the youngest patients (PG 1) median and paramedian. In PG 2 and PG 3, the posterior height change is very small. That is the reason why the anteroposterior comparison reveals a much more pronounced height increase anteriorly than posteriorly.ConclusionThe comparison of selected CBCT data with a dental cast analysis allows the conclusion that the maxillary expansion after RME in children up to 10 years is rather parallel, whereas it occurs V‑shaped (anterior > posterior transversal, inferior > superior vertical) with increasing age, especially in adolescents from the age of 12. In addition to an age-progressive rigidity of the pterygopalatomaxillary junction, morphological changes of the transverse palatine suture during growth seem to be causal. Thus, age-dependent effects of palatal expansion occur due to a positional change of maxillary centres of rotation and resistance. From dental cast measurements, especially at the skeletal–basal level, conclusions can be drawn about the median palatal suture opening mode.

Does the face mask increase the impact of rapid maxillary expansion on sagittal airway dimensions?

Airway dimensions associated with the transversal and sagittal position of the maxilla are affected by orthodontic treatment. The objective of this study was to compare the effects of rapid maxillary expansion (RME) and RME followed by face mask (FM) therapies on the airway space and investigate whether application of the FM increases the short-term and long- term impact of RME on sagittal airway dimensions. A total of 26 patients were divided into two groups. Group I included 14 adolescents treated with RME (3 males, 11 females; mean age: 12.2 11 ± 2.1 years), and Group II included 12 adolescents treated with RME followed by FM therapy (7 males, 5 females; mean age: 11.6 ± 1.3 years). Sagittal and vertical skeletal measurements, as well as ten linear cross-sectional airway measurements, were calculated from pretreatment, posttreatment, and postretention cephalometric radiographs. RME followed by FM resulted in a significant increase in the SNA angle, ANB angle, and Wits parameter by the forward movement of the maxillary bone. A significant increase in the vertical dimensions was also observed. Regarding the airway measurements in both groups, significant oropharyngeal increases were revealed, and these were maintained in the follow-up period. However, there were no other significant differences in the short-term and long-term results obtained for Groups I and II. The dimensions of the airway were significantly affected by both therapies. However, no additional effect of FM was observed.

Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective.

Background. To evaluate the possible effects of Rapid Maxillary Expansion (RME), such as nasal breathing problems, middle ear function, Obstructive Sleep Apnea (OSA) in the otolaryngology field. RME has already been introduced in orthodontics to expand the maxilla of young patients affected by transversal maxillary constriction. Methods. A literature search was performed using different databases (Medline/PubMed, EMBASE, and CINAHL), from May 2005 to November 2021, according to the PRISMA guidelines. Results. The application of RME in children has shown good results on nasal function, reducing nasal resistances, independently from a previous adenotonsillectomy. These results are not only related to the increasing of nasal transverse diameters and volume, but also to the stiffening of airway muscles, enabling the nasal filtrum function and avoiding mouth opening, thereby decreasing respiratory infections. Positive effects have also been reported for the treatment of conductive hearing loss and of OSA, with the reduction of Apnea Hypopnea Index (AHI), possibly due to (i) an increased pharyngeal dimensions, (ii) a new tongue posture, and (iii) reduced nasal respiratory problems. Conclusions. Otolaryngologists should be aware of the indications and benefits of the RME treatment, considering its possible multiple beneficial effects.

Three dimensional evaluation of the effect of rapid maxillary expansion on maxillary sinus volume

AimTo compare the maxillary sinus volume (MSV) of posterior cross bite (PCB) patients before and after rapid maxillary expansion (RME) by cone-beam computed tomography (CBCT). MethodsA total of 24 patients’ CBCT scans that underwent RME therapy for their orthodontic treatment were used. CBCTs were obtained before (T1), immediately after (T2), and 6 months after (T3) RME. MSVs were calculated by using the 3D module of Dolphin 11.0 software. Repeated measures ANOVA (RMANOVA) was used to identify the MSV differences. ResultsThe results showed no significant differences between the right and left MSVs of the T1 group (p>.05). No significant differences were found between the right and left side MSV of the T2 group (p>.05). There were no significant differences between the right and left side MSV of the T3 group (p>.05). According to the intergroup comparisons, the RMANOVA test results revealed statistically significant right (F = 459.37, p<.001), left (F = 409.34, p<.001), and mean (F = 489.33, p<.001) MSV differences between groups. Multiple comparisons of the right, left, and mean MSV between the T1 and T2, T2 and T3, and T1 and T3 groups with Bonferroni's test revealed no significant differences between the T1 and T2 (p>.05) and T2 and T3 (p>.05) groups. However, significant differences were found in the right (p<.05), left (p<.05), and mean (p<.05) MSV between the T1 and T3 groups. The right, left, and mean MSV of the T3 group were significantly higher than those of the T1 group. ConclusionNo significant change was detected in the MSV immediately after RME. However, MSV was significantly increased at the end of the retention period.

Effects of rapid maxillary expansion on head and cervical posture in growing patients: A systematic review

To identify and qualify the evidence of published studies evaluating whether rapid maxillary expansion (RME) treatment modifies the head and cervical posture in growing patients. Electronic database searches were conducted until January 2021 using PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and LILACS. Grey literature was explored using ClinicalTrials, OpenGrey and Google Scholar. Trials involving participants who underwent RME were included. Risk of Bias (RoB) assessment was conducted using the Cochrane tool for randomized trials and the Methodological Index for Non-randomized Studies (MINORS) for non-randomized trials. The certainty level of evidence was evaluated through the Grading of Recommendations, Assessment, Development and Evaluation tool (GRADE). Six clinical trials were included. The RoB scores had unclear and high risks of bias. Low certainty of evidence suggested that the effects following RME include a decrease in craniocervical angulation, as well as a very low certainty of evidence for a decrease in head elevation, an increase in cervical lordosis, and an increase in the inclination of the cervical spine. There is low and very low evidence that RME alters the head and cervical posture in growing patients. Further investigation regarding long-term effects, possible changes due to somatic growth, and clinical relevance is needed.