Effect of Rapid Maxillary Expansion on Upper Airway Morphology: A Retrospective Comparison of Normal Patients versus Patients with Enlarged Adenoid Tissue.

2021 ◽  
Vol 45 (3) ◽  
pp. 208-215
Author(s):  
Xin Feng ◽  
Stein Atle Lie ◽  
Kristina Hellén-Halme ◽  
Xie-Qi Shi
Keyword(s):  
Nasal Obstruction ◽  
Upper Airway ◽  
3D Models ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

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 < 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.

scholarly journals The effect of rapid maxillary expansion on the upper airway’s aerodynamic characteristics

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xin Feng ◽  
Yicheng Chen ◽  
Kristina Hellén-Halme ◽  
Weihua Cai ◽  
Xie-Qi Shi
Keyword(s):  
Cfd Simulation ◽  
Three Dimensional ◽  
Upper Airway ◽  
3D Models ◽  
Aerodynamic Characteristics ◽  
Rapid Maxillary Expansion ◽  
Wilcoxon Test ◽  
Maxillary Expansion ◽  
Significant Difference ◽  
Group 2

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.

scholarly journals The Effect of Rapid Maxillary Expansion on the Upper Airway’s Aerodynamic Characteristics

2020 ◽  
Author(s):  
Xin Feng ◽  
Yicheng Chen ◽  
Kristina Halme ◽  
Weihua Cai ◽  
Xie-Qi Shi
Keyword(s):  
Pressure Drop ◽  
Cfd Simulation ◽  
Maximum Velocity ◽  
Upper Airway ◽  
Aerodynamic Characteristics ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Airway Function ◽  
Group 2 ◽  
Group 1

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 upper airway function in terms of airflow resistance 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, midsagittal maximum velocity, and maximum wall shear stress were compared by independent samples t-test between the two groups at T0 and T1. Results: At T0, the pressure drop at expiration was significantly higher in group 2 compared to group 1, whereas the difference between the two groups was not significant at T1. The midsagittal maximum velocity of the two groups decreased to some extent at expiration, but without significant difference. The midsagittal maximum velocity of group 2 was at inspiration significantly higher than that of group 1 at T0 and T1. Conclusion: RME had a positive effect on UA airflow resistance in patients with an AN ratio ≥ 0.6. The findings provide positive evidence of RME in airway function and should thus be recommended to patients with both a narrow maxilla and enlarged adenoid.

scholarly journals Changes in the Upper and Lower Pharyngeal Airway Spaces Associated with Rapid Maxillary Expansion

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Fitin Aloufi ◽  
Charles B. Preston ◽  
Khalid H. Zawawi
Keyword(s):  
Orthodontic Treatment ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Lower Airway ◽  
Control Group ◽  
Maxillary Expansion ◽  
Pharyngeal Airway ◽  
Significant Difference ◽  
And Gender ◽  
Maxillary Constriction

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.

scholarly journals Molar Changes with Cervical Headgear Alone or in Combination with Rapid Maxillary Expansion

2008 ◽  
Vol 78 (5) ◽  
pp. 847-851 ◽  
Author(s):  
Marcel Marchiori Farret ◽  
Eduardo Martinelli S. de Lima ◽  
Vanessa Pereira Araújo ◽  
Susana Maria Deon Rizzatto ◽  
Luciane Macedo de Menezes ◽  
...  
Keyword(s):  
Class Ii ◽  
Rapid Maxillary Expansion ◽  
Control Group ◽  
Maxillary Expansion ◽  
Lateral Cephalograms ◽  
Cervical Traction ◽  
Permanent Molars ◽  
Group 2 ◽  
First Permanent Molars ◽  
Group 1

Abstract Objective: To test the hypothesis that there is no difference in the distal movement of the maxillary first permanent molars when cervical headgear is used alone or in combination with rapid maxillary expansion. Materials and Methods: The sample was composed of 36 subjects (aged 9 to 13 years), treated in the Faculty of Dentistry, Pontifícia Universidade Cat;aaolica, Rio Grande do Sul, Brazil. The individuals were in good health and in their pubertal growth period. All had Class II division 1 malocclusion. The patients were divided into two groups: group 1 (22 subjects), Class II, with a normal transverse maxilla treated with cervical traction headgear (HG) 400 g 12 h/d, and group 2 (14 subjects), Class II maxillary transverse deficiency treated with rapid maxillary expansion plus cervical traction headgear (RME + HG). An additional group 3 (17 subjects) served as a control group and included individuals with the same characteristics. All subjects had two lateral cephalograms: initial (T1) and progress (T2), taken 6 months later. Differences between T1 and T2 were compared with the Student's t-test, and three groups were compared by the analysis of variance and Tukey multiple comparison test. Results: Results showed greater distal tipping and greater distal movement of the first permanent molars in group 1 (HG) than in group 2 (RME + HG), P &lt; .05. No extrusion of first permanent molar occurred in either group (P &gt; .05). Conclusion: The hypothesis was rejected. Cervical traction headgear alone produced greater distal movement effects in maxillary first permanent molars when compared with rapid maxillary expansion associated with cervical headgear.

scholarly journals Stability in Dental Changes in RME and SARME: A 2-Year Follow-up

2009 ◽  
Vol 79 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Oral Sokucu ◽  
H. Huseyin Kosger ◽  
A. Altug Bıcakci ◽  
Hasan Babacan
Keyword(s):  
Orthodontic Treatment ◽  
Rapid Maxillary Expansion ◽  
Study Group ◽  
Maxillary Expansion ◽  
Patient Groups ◽  
Group 2 ◽  
Maxillary Arch ◽  
Group 1 ◽  
Dental Casts

Abstract Objective: To compare the effects of rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME) on dentoalveolar structures following orthodontic treatment, as well as stability at 2-year follow-up. Materials and Methods: Two groups of subjects were used in the study. Group 1 consisted of 14 subjects (mean age, 12.7 ± 1.4 years) who were treated with RME, and Group 2 consisted of 13 subjects (mean age, 18.5 ± 2.3 years) who were treated with SARME. In both groups, all cases had a maxillary width deficiency with bilateral crossbites. Maxillary dental casts were available at three different intervals: pretreatment (T1), after orthodontic treatment (T2), and at follow-up recall (T3). Intermolar and interpremolar width, palatal height, and maxillary arch depth and length were assessed from maxillary dental casts. Results: Treatment by RME and SARME produced significant increases in intermolar and interpremolar width and maxillary arch length after expansion (T2) (P &lt; .05). The amount of relapse was not significantly different 2 years after treatment (P &gt; .05). Conclusions: Although age ranges of the patient groups are different, the dentoalveolar responses of RME and SARME were similar after orthodontic treatment. (Angle Orthod. 2009:79; )

scholarly journals The effects of interprofessional diabetes education on the knowledge of medical, dentistry and nursing students

2018 ◽  
Vol 46 (2) ◽  
pp. 145
Author(s):  
Maja Račić ◽  
Bojan N. Joksimović ◽  
Smiljka Cicmil ◽  
Srebrenka Kusmuk ◽  
Nedeljka Ivković ◽  
...  
Keyword(s):  
Interprofessional Education ◽  
Multiple Choice Questions ◽  
Self Assessment ◽  
Cross Sectional ◽  
Mean Values ◽  
Significant Difference ◽  
Teamwork Skills ◽  
Group 2 ◽  
The Impact ◽  
Group 1

<div class="WordSection1"><p><strong>Objectives</strong>. Interprofessional teamwork is best attained through education that promotes mutual trust and effective communication. The primary aim of the study was to evaluate the impact of interprofessional learning on knowledge about diabetes. <strong>Methods</strong>. The cross-sectional study included students of medicine, dentistry and nursing at the Faculty of Medicine Foča, Bosnia and Herzegovina. The students were randomly allocated into one of two groups. Group 1 attended an interprofessional course on diabetes while group 2 was divided into three subgroups and each of the subgroups attended an uniprofessional diabetes course. The measuring instrument used in the course in order to assess the participants’ knowledge about diabetic care was a test containing multiple-choice questions about diabetes. The Interprofessional Questionnaire was used to explore the attitudes, views, values and beliefs of students regarding interprofessional education (IPE). <strong>Results</strong>. No statistically significant difference in total score on the test was found between the groups at baseline, but at follow-up the difference was highly statistically significant (F=10.87; p=0.002). The students from Group 1 had better results (21.82 points), compared to Group 2 (18.77 points). The statistically significant difference was observed in mean values (t=-3.997; p=0.001), between Groups 1 and 2; the students from Group 1 obtained 20.42 points, which is considered to indicate a respectively positive self-assessment of communication and teamwork skills. However, Group 2 indicated a negative self-assessment of communication and teamwork skills. <strong>Conclusion</strong>. The findings suggest that IPE activities may provide health profession students with valuable collaborative learning opportunities.</p></div>

scholarly journals Changes in retina's vascular and nervous structures in patients with hypertension

2021 ◽  
Author(s):  
Run-ze Zhao ◽  
Melba Márquez Fernández ◽  
Maria Cáceres Toledo ◽  
Teddy Osmin Tamargo Barbeito ◽  
Guo-xun Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cross Sectional Study ◽  
Hypertensive Retinopathy ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Cross Sectional ◽  
Significant Difference ◽  
Group 2 ◽  
Post Hoc ◽  
Group 1

Abstract Introduction: This study aims to analyze the correlation between hypertension (HTN) and changes in the retina's vascular and nervous structures in patients with hypertension.Method: This was a cross-sectional study, which included a group of 45 subjects who did not suffer from hypertension (HTN) (Group 1), other two groups of 51 patients with controlled (Group 2) and not controlled (Group 3) HTN. Changes in vascular and nervous structures were identified and evaluated by ophthalmoscopy and OCT, respectively. Parametric and non-parametric tests, Post-hoc, Pearson, and Spearman correlation were used, with p<0.05 considered statistically significant.Results: We observed hypertensive retinopathy (HTNR G I and II) in both groups with HTN, with a significant difference (p=0.023). We found a lower average retinal nerve fiber layer (RNFL), the average and minimum ganglion cell complex (GCC) in the patients of groups 2 and 3 than those of group 1. We found a negative and slight correlation between systolic blood pressure (SBP), diastolic blood pressure (DBP), and HTNR with superior GCC thickness in hypertensive patients.Conclusions: hypertension correlated to changes in the retina's vascular and nervous structures, and the nervous structure alterations were not visible by ophthalmoscopy but detected by OCT.

scholarly journals Comparison of Transversal Effects of Different Expansion Protocols: Alt-RAMEC versus RME

2021 ◽  
Vol 7 (2) ◽  
pp. 43-48
Author(s):  
Burak Kale ◽  
Muhammed Hilmi Büyükçavuş
Keyword(s):  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Treatment Protocols ◽  
Significant Difference ◽  
Expansion Protocol ◽  
Group 2 ◽  
Width Measurements ◽  
Student’S T ◽  
Digital Caliper ◽  
Student’S T Test

Abstract Objectives The aim of this study is evaluate the transversal effects of the Alt-RAMEC(Alternate Rapid Maxillary Expansion and Constriction) protocol on both craniofacial and dentoalveolar structures and to compare the transversal effects of the RME(Rapid Maxillary Expansion) protocol. Materials and Methods In our archive, selected patients were divided into two groups. Group 1 included 22 patients(12boys,10girls, mean age 11.61±2.11years) who had been treated with 5 weeks of Alt-RAMEC. Group 2 comprised 21 patients(11boys,10girls, mean age 11.66±1.23years) who had been treated with 1 week of RME. Transversal measurements were also performed on the study models pre-(T0) and post-treatment(T1) with digital caliper. Internasal, interzygomatic, interjugular and intergonial width measurements were made on posteroanterior radiographs. The initial measurements and the mean changes within the groups were analysed using a student’s t test. Results According to the results of the study, there was no statistically significant difference between the groups in terms of chronological age, gender distribution and initial values. The expansion protocols showed a statistically significant increase in the widths of intercanine, interpremolar, intermolar and alveolar base widths in the maxilla(p<0.05). No statistically significant changes were observed in both groups(p>0.05) in mandible. The changes in maxillary intercanine, interpremolar widths between the two groups were statistically significant(p<0.05). In the posteroanterior measurements, only statistically significant difference was found between the groups in internasal width(p<0.05). Conclusions Alt-RAMEC and RME protocols are effective treatment protocols for correction of transverse deficiency in growing patients. 5-weeks Alt-RAMEC protocol significantly increased intercanine and interpremolar widths compared to 1-week RME.  Clinical Relevance Since there are no studies in the literature comparing the effects of two different expansion protocols in the transverse direction, this is both the first. Most importantly, clinicians will see which of these two protocols is more singular in the treatment of transversal problems. Keywords: RME, Alt-RAMEC, tranversal measurements

scholarly journals The effect of coronary angiography and femoral access on femoral artery distensibility and elasticity

2021 ◽  
Vol 21 (84) ◽  
pp. e48-e52
Author(s):  
Aylin Güneşli ◽  
◽  
Aynur Acıbuca ◽  
Keyword(s):  
Coronary Angiography ◽  
Femoral Artery ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Femoral Access ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim of the study: The aim of this study was to evaluate the long-term effects of access to the femoral artery for the purposes of coronary angiography through the measurement of femoral artery distensibility and elasticity on the accessed and non-accessed sides. Material and methods: This cross-sectional study included patients who underwent femoral angiography at least 1 year previously. Those whose femoral artery was accessed once formed Group 1 (n = 59), those who were accessed twice formed Group 2 (n = 57), those accessed 3 times formed Group 3 (n = 55), and those with more than 3 accesses, Group 4 (n = 60). The groups were compared in respect of femoral artery elasticity and distensibility in the accessed and non-accessed sides. Results: No statistically significant difference was determined in respect of femoral distensibility and elasticity in Group 1 (9.40 ± 0.84 vs 9.48 ± 0.75, p = 0.107 and 0.23 ± 0.03 vs 0.23 ± 0.03, p = 0.433, respectively). However, a significant difference was observed between the two sides in terms of distensibility and elasticity in Group 2 (9.02 ± 0.81 vs 9.23 ± 0.75, and 0.21 ± 0.02 vs 0.22 ± 0.02), in Group 3 (8.49 ± 0.77 vs 9.18 ± 0.9 and 0.19 ± 0.02 vs 0.21 ± 0.02), and in Group 4 (8.14 ± 0.74 vs 9.03 ± 0.81 and 0.16 ± 0.01 vs 0.2 ± 0.02, p <0.001, for all comparisons). Conclusion: While a single access in the femoral artery for coronary angiography does not affect femoral artery elasticity and distensibility, multiple accesses may have adverse effects.

scholarly journals Dental and skeletal effects of combined headgear used alone or in association with rapid maxillary expansion

2015 ◽  
Vol 20 (5) ◽  
pp. 43-49
Author(s):  
Milton Meri Benitez Farret ◽  
Eduardo Martinelli de Lima ◽  
Marcel M. Farret ◽  
Laura Lutz de Araújo
Keyword(s):  
Side Effects ◽  
Rapid Maxillary Expansion ◽  
Class Ii Malocclusion ◽  
Maxillary Expansion ◽  
Clockwise Rotation ◽  
Maxillary Molars ◽  
Skeletal Effects ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: The aim of this study was to assess the effects of combined headgear used alone or in association with rapid maxillary expansion, as the first step for Class II malocclusion treatment.Methods:The sample comprised 61 patients divided into three groups: Group 1, combined headgear (CH); Group 2, CH + rapid maxillary expansion (CH + RME); and Group 3, control (CG). In Group 1, patients were treated with combined headgear until Class I molar relationship was achieved. In Group 2, the protocol for headgear was the same; however, patients were previously subject to rapid maxillary expansion.Results:Results showed distal displacement of maxillary molars for both experimental groups (p < 0.001), with distal tipping only in Group 1 (CH) (p < 0.001). There was restriction of forward maxillary growth in Group 2 (CH + RME) (p < 0.05) and clockwise rotation of the maxilla in Group 1 (CH) (p < 0.05).Conclusion: Based on the results, it is possible to suggest that treatment with both protocols was efficient; however, results were more significant for Group 2 (CH + RME) with less side effects.

Sign in / Sign up

Export Citation Format

Share Document