scholarly journals Three-dimensional evaluation of upper airway changes following rapid maxillary expansion: A retrospective comparison with propensity score matched controls

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261579
Author(s):  
Hussein Aljawad ◽  
Kyung-Min Lee ◽  
Hoi-Jeong Lim

Background The aim of this study is to evaluate upper airway changes three-dimensionally following rapid maxillary expansion (RME) and compare the changes with matched controls. Materials and methods Seventeen patients (mean age 12.6 ± 1.8 years) with maxillary transverse deficiency were treated with RME. Using the propensity score matching method, 17 patients (mean age 12.3 ± 1.5 years) were selected from a non-RME control group of 33. Case-control matching was performed based on 5 covariates: age, gender, CBCT scan interval, sagittal skeletal pattern, and tongue posture. Airway volumes of nasopharynx and oropharynx and minimum cross-sectional areas (MCA) of oropharynx were measured and compared between the case and control groups in CBCT scan images. Results In the case group, significant increases from before to after RME were found in all measurements except MCA of the retroglossal segment of oropharynx. Before treatment, there were no significant differences between case group and control group. While comparing the case group with the control group after treatment showed overall greater increases in the case group. In particular, MCA of retropalatal segment showed statistically significant differences. Conclusion The results of this study indicate that RME causes an increase in upper airway dimensions.

2013 ◽  
Vol 84 (2) ◽  
pp. 265-273 ◽  
Author(s):  
Hakan El ◽  
Juan Martin Palomo

ABSTRACT Objectives: To evaluate, by using cone beam computed tomography, the skeletal, dental, oropharyngeal (OP) airway volume, and nasal passage (NP) volume changes that occur after rapid maxillary expansion (RME). Materials and Methods: Two groups were selected, each with 35 patients (15 males, 20 females), an RME group (mean age, 14.02 ± 1.46 years) and a control group (mean age, 14.10 ± 1.44 years). The RME group consisted of patients with maxillary constriction who were treated with Hyrax palatal expanders, and the control group comprised age- and sex-matched patients who underwent comprehensive orthodontic treatment without the use of a rapid maxillary expander. Results: All of the transverse skeletal (medial orbital width, lateral nasal width, maxillary width, and mandibular width) and interdental (intermolar, interpremolar, and intercanine) parameters were significantly enlarged in the RME group. A statistically significant increase in airway variables was seen in both groups between pretreatment (T0) and final records (T1). The mean increase of NP airway volume for the RME group (1719.9 ± 1510.7 mm3) was twofold compared with the control group (813.6 ± 1006.7 mm3), and no intergroup significant difference was found for the OP volume. Conclusions: Rapid maxillary expansion creates a significant increase in nasal passage airway volume but no significant change in the oropharyngeal airway volume.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Fitin Aloufi ◽  
Charles B. Preston ◽  
Khalid H. Zawawi

Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group ( mm) compared to the control group ( mm), . However, there was no significant difference in the lower pharyngeal airway measurement between the RME group () and the control group (), . There was no significant difference with respect to mode of breathing between the two groups (). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Davide Cavagnetto ◽  
Andrea Abate ◽  
Alberto Caprioglio ◽  
Paolo Cressoni ◽  
Cinzia Maspero

Abstract Background There is currently no information on how different mandibular segments are affected by juvenile idiopathic arthritis. The aim of this paper is to assess volumetric differences of different mandibular segments in subjects with unilateral and bilateral JIA and to compare them with non-JIA control volumes. Materials and methods Forty subjects with unilateral TMJ involvement and 48 with bilateral TMJ involvement were selected for the case group and 45 subjects with no known rheumatic comorbidities for the control group. The mandible of each subject was divided according to a validated method into different paired volumes (hemimandible, condyle, ramus and hemibody). Results The ANOVA test revealed a statistically significant difference in all the groups for condylar and ramus volumes, and the pairwise comparison evidenced a statistically significant higher condylar and ramus volume in the control group (1444.47 mm3; 5715.44 mm3) than in the affected side in the unilateral JIA group (929.46 mm3; 4776.31 mm3) and the bilateral JIA group (1068.54 mm3; 5715.44 mm3). Moreover, there was also a higher condylar volume in the unaffected side in the unilateral JIA group (1419.39 mm3; 5566.24 mm3) than in the bilateral JIA group and the affected side in the unilateral JIA group. Conclusions The affected side of unilateral JIA patients showed statistically significant lower volumes in the hemimandible, in the condyle and in the ramus. The largest total mandibular volume was observed in the control group, followed by the unilateral JIA group and, lastly, by the bilateral JIA group.


2011 ◽  
Vol 81 (5) ◽  
pp. 850-855 ◽  
Author(s):  
Ahmet Yagci ◽  
Tancan Uysal ◽  
Serdar Usumez ◽  
Metin Orhan

Abstract Objective: To identify the effect of rapid maxillary expansion (RME) procedure on dynamic measurement of natural head position (NHP). Materials and Methods: The treatment group comprised 23 patients, 12 girls and 11 boys (mean age: 10.1 ± 1.1 years), and the control group comprised 15 subjects, 8 girls and 7 boys (mean age: 9.7 ± 1.4 years). The test subjects underwent RME treatment using full cap acrylic device, and the mean amount of expansion was 5.48 mm. An inclinometer and a portable data logger were used to collect the NHP data. Intragroup changes were evaluated by using nonparametric Wilcoxon test, and intergroup changes were analyzed with Mann-Whitney U-test. P values less than .05 were considered statistically significant. Results: The mean difference between initial and final NHP was 0.31°, and this difference was not statistically significant. Also, there were no statistically significant differences between the RME and control groups before and after treatment. Conclusion: Treatment with the RME procedure showed no statistically significant effects on dynamic measurement of NHP when compared with initial values or untreated control.


Folia Medica ◽  
2018 ◽  
Vol 60 (4) ◽  
pp. 632-636
Author(s):  
Gilmar Pereira Silva ◽  
Vítor Pereira Xavier Grangeiro ◽  
Fabiana Pirani Carneiro

Abstract Background: We proposed to investigate the possible relationship between seminal quality and ferritin and transferrin seminal levels in chronic hemodialysis (CH) patients. Materials and methods: This is a cross-sectional study in a group of 60 men (case) undergoing CH for more than 6 months, and a group of 30 healthy men (control), aged 18-60 years, without clinical or laboratory signs of infection/inflammation and eugonadic. A spermogram was performed by manual method and measured the ferritn and transferrin seminal levels. Results: The case and control groups were age-matched (49.47±5.56 versus 47.90±6.22, p = 0.229). Comparison between case and control group, the exception of seminal ferritin levels that were similar (p = 0.136), were significantly lower in the case group (p<0.001) for all constituents of the seminal parameter and seminal transferrin levels. Seminal ferritin does not appear to be associated with seminal parameters and seminal transferrin (p>0.05); but there was an association between seminal transferrin and seminal parameters (p<0.001). Conclusions: Our results suggest that seminal quality is related to seminal transferrin level and not with seminal ferritin level being useful in the initial evaluation of chronic hemodialysis patients with clinical suspicion of sub / infertility.


Author(s):  
MUARA P. LUBIS

Objective: Preeclampsia characterized systematically by extensive vascular endothelial dysfunction and microangiopathy on mother, dNK is very important for the success of placentation. They are the key mediator of maternal immune system interactions with fetal cells. dNK cells are also involved in the modulation of EVT and the remodeling of spiral arteries. Methods: Analytic research with cross-sectional study, with samples of pregnant women who suffer from severe PE and aterm pregnancy which came to H. Adam Malik Hospital and Networking Hospital, November 2015-April 2016. The samples are 46 women, who met the inclusion criteria. Results: Immunohistochemistry examination dNK cell in the severe PE case group and control group, statistically found p<0,05. dNK placenta expression in the severe preeclampsia case group gives an overview of expression with a mean of 2.55±2.31, while the control group of normal pregnancy had higher mean is 8.66±3.16. Conclusion: The examination of immunohistochemistry of dNK cells showed there is a significant difference in the expression of Immuno-histochemistry dNK cells between severe PE case group and non severe PE.


2019 ◽  
Vol 57 (3) ◽  
pp. 371-377 ◽  
Author(s):  
Alexandre de Almeida Ribeiro ◽  
Francis Joel Smith ◽  
Hugo Nary Filho ◽  
Inge E. K. Trindade ◽  
Cristiano Tonello ◽  
...  

Objectives: The purpose of this investigation was to assess the pharyngeal dimensions and the craniofacial morphology of individuals with Treacher Collins syndrome (TCS) when compared to vertical skeletal class II individuals. It is our hypothesis that the upper airways of individuals with TCS are reduced in view of the skeletal pattern and the maxillomandibular dysmorphologies. Materials and Methods: Cone-beam computed tomography scans of 26 individuals had the pharyngeal volume (V) and minimal cross-sectional area (mCSA) evaluated. Study group (TCS) was formed by 13 scans of patients with TCS (7 males and 6 females; 20.2 ± 4.7 years). Control group (CG) assembled 13 scans of nonaffected individuals with the same type of skeletal pattern (2 males and 11 females; 26.6 ± 5.4 years). Cephalometric data of maxillomandibular position, maxillomandibular dimensions, and growth pattern were assessed. Statistical analysis ( P ≤ .05) included Student t test and Pearson correlation coefficient. Results: Although reduced, pharyngeal V and mCSA of TCS were not statistically different from the CG. On both groups, mCSA was mostly at the oropharyngeal level. Individuals with TCS presented retrognathic chin, reduced maxillomandibular dimensions, and increased clockwise rotation of the palatal plane. Maxillary and mandibular lengths were correlated with pharyngeal V and mCSA. Conclusions: The pharyngeal dimensions of individuals with TCS are impacted by the micrognathia and retrognathia. In association with the skeletal pattern, the reduction of the airways, although not statistically significant, may explain the increased prevalence of airways disorder in this syndrome.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xin Feng ◽  
Yicheng Chen ◽  
Kristina Hellén-Halme ◽  
Weihua Cai ◽  
Xie-Qi Shi

Abstract Background The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aerodynamic characteristics by applying a computational fluid dynamics (CFD) simulation. Methods This retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three-dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop (ΔP), maximum midsagittal velocity (Vms), and maximum wall shear stress (Pws) were compared by paired t-test and Wilcoxon test according to the normality test at T0 and T1. Results The aerodynamic characteristics in UA revealed no statistically significant difference after RME. The maximum Vms (m/s) decreased from 2.79 to 2.28 at expiration after RME (P = 0.057). Conclusion The aerodynamic characteristics were not significantly changed after RME. Further CFD studies with more cases are warranted.


2021 ◽  
Vol 45 (3) ◽  
pp. 208-215
Author(s):  
Xin Feng ◽  
Stein Atle Lie ◽  
Kristina Hellén-Halme ◽  
Xie-Qi Shi

Objectives The present study evaluated the effect of rapid maxillary expansion (RME) on the morphology of the upper airway (UA) by calculating cross-sectional areas and volumes and comparing the effect in patients with a normal-sized adenoid with the effect in patients with an enlarged adenoid. Study design: Seventeen patients met the inclusion criteria. We constructed 3D models of the UA on cone-beam computed tomography images to calculate cross-sectional areas and volumes at the levels of the nasopharyngeal, retropalatal, and retroglossal airways. Patients were divided into two groups: group 1 was comprised of patients with an adenoidal nasopharyngeal (AN) ratio &lt; 0.6 and group 2 with an AN ratio ≥ 0.6. Paired samples t-tests assessed any area and volumetric changes of the UA after RME. Changes in degree of nasal obstruction, calculated as the AN ratio, was then compared for the two groups. An independent samples t-test compared volumetric changes in the nasopharynx between the two groups before and after RME. Results Changes in cross-sectional areas and volumes of the UA due to RME were not significant. The effects of RME on AN ratio (11 % vs 0 %) and nasopharyngeal volume (36.8 % vs 5.97%) were somewhat larger in group 2 patients who had adenoid-associated nasal obstruction compared with group 1 patients with a normal-sized adenoid; however, the differences were not significant. Conclusions After RME, the patients with an enlarged adenoid had more increases in nasopharyngeal volume compared with those with normal adenoid, despite there was no significant difference.


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