Purpose The aim of this randomized clinical trial was to evaluate the
effects of tooth tissue-borne (TTB), tooth-borne (TB), and bone-borne
(BB) rapid maxillary expansion appliances on obstructive sleep apnea
(OSA) severity. Trial design Three-arm parallel randomized controlled
trial. Methods This study was designed in parallel with an allocation
ratio of 1:1:1. Forty six patients with narrow maxilla and diagnosis of
OSA recruited from the Department of Orthodontics, ### University
were randomly assigned to three groups according to appliance used:
tooth tissue-borne, tooth-borne and bone-borne expanders. The primary
outcome of this study included polygraphic change in sleep parameters.
Secondary outcome was the correction of posterior crossbite. Each
subject underwent overnight sleep test with polygraphy at baseline and 3
month-follow-up of treatment. Randomization was performed using a
computer-generated randomization program The outcome assessor was
blinded to group assignment. For the statistical analysis,
Kruskal-Wallis analysis and Dunn-Bonferroni tests were used for
inter-group comparisons and Wilcoxon analysis was used for intra-group
evalaution. p<0.05 was accepted statistically significant.
Results The amount of expansion in maxillary width and upper intermolar
width were similar in all goups (95% confidence interval [CI],
p>0.05). The groups were similar in terms of apnea-hypopnea
index (AHI) and oxygen saturation parameters at baseline (95% [CI],
p>0.05). After 3 months of treatment, there was no
significant decrease in AHI and oxygen desaturation index, and no
increase in minimum and mean oxygen saturations (95% [CI],
p>0.05). Supine AHI values were decreased by the tooth
tissue-borne and tooth-borne appliances, but these changes were not
significant (95% [CI], p>0.05). Harms No serious harm
ocurred except mild gingivitis. Conclusions Similar skeletal and dental
expansion of maxilla were observed after RME with all expanders.
Although the decrease in AHI was not significant, RME can be used as an
adjunct to the primary treatment in OSA patients.
Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial
