scholarly journals Three-dimensional evaluation of upper airway following rapid maxillary expansion: A CBCT study

2013 ◽  
Vol 84 (2) ◽  
pp. 265-273 ◽  
Author(s):  
Hakan El ◽  
Juan Martin Palomo
Keyword(s):  
Three Dimensional ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Control Group ◽  
Nasal Passage ◽  
Maxillary Expansion ◽  
Oropharyngeal Airway ◽  
Significant Difference ◽  
Group A ◽  
Maxillary Constriction

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.

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 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 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
Keyword(s):  
Propensity Score ◽  
Three Dimensional ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Control Group ◽  
Case Group ◽  
Maxillary Expansion ◽  
Cross Sectional ◽  
Skeletal Pattern ◽  
And Control

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.

scholarly journals Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

Materials ◽  
2021 ◽  
Vol 14 (5) ◽  
pp. 1152
Author(s):  
Rafał Nowak ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Roman Frątczak ◽  
Ewa Zawiślak
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Three Dimensional ◽  
Element Model ◽  
Rapid Maxillary Expansion ◽  
Stress Distributions ◽  
Maxillary Expansion ◽  
Facial Skeleton ◽  
Element Analysis ◽  
Maxillary Constriction

The aim of this study was to compare the reduced stresses according to Huber’s hypothesis and the displacement pattern in the region of the facial skeleton using a tooth- or bone-borne appliance in surgically assisted rapid maxillary expansion (SARME). In the current literature, the lack of updated reports about biomechanical effects in bone-borne appliances used in SARME is noticeable. Finite element analysis (FEA) was used for this study. Six facial skeleton models were created, five with various variants of osteotomy and one without osteotomy. Two different appliances for maxillary expansion were used for each model. The three-dimensional (3D) model of the facial skeleton was created on the basis of spiral computed tomography (CT) scans of a 32-year-old patient with maxillary constriction. The finite element model was built using ANSYS 15.0 software, in which the computations were carried out. Stress distributions and displacement values along the 3D axes were found for each osteotomy variant with the expansion of the tooth- and the bone-borne devices at a level of 0.5 mm. The investigation showed that in the case of a full osteotomy of the maxilla, as described by Bell and Epker in 1976, the method of fixing the appliance for maxillary expansion had no impact on the distribution of the reduced stresses according to Huber’s hypothesis in the facial skeleton. In the case of the bone-borne appliance, the load on the teeth, which may lead to periodontal and orthodontic complications, was eliminated. In the case of a full osteotomy of the maxilla, displacements in the buccolingual direction for all the variables of the bone-borne appliance were slightly bigger than for the tooth-borne appliance.

scholarly journals Rapid maxillary expansion: Do banded teeth develop more external root resorption than non-banded anchorage teeth?

2015 ◽  
Vol 86 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Débora C Martins ◽  
Bernardo Q Souki ◽  
Paula L Cheib ◽  
Gerluza A.B Silva ◽  
Igor D.G Reis ◽  
...  
Keyword(s):  
Root Resorption ◽  
Rapid Maxillary Expansion ◽  
Control Group ◽  
Maxillary Expansion ◽  
Orthodontic Anchorage ◽  
External Root Resorption ◽  
Significant Difference ◽  
Band Group ◽  
Orthodontic Forces ◽  
Root Surfaces

ABSTRACT Objective:  To compare external root resorption (ERR) when bands and wires are used as orthodontic anchorage during rapid maxillary expansion (RME). Materials and Methods:  Histologic analysis was performed on 108 sites from 18 maxillary first premolars and on 36 sites from six mandibular first premolars in nine subjects (mean age = 15.2 ± 1.4 years) 3 months after RME. Maxillary teeth were pooled into two groups (n = 54 each) according to the type of orthodontic anchorage (band group [BG] vs wire group [WG]). Anchorage type was randomly chosen in a split-mouth design. Mandibular first premolars, which were not subjected to orthodontic forces, were used as the control group (CG). Results:  All premolars in the BG and WG showed ERR at the level of the cementum and dentin. Repair with cementum cells was observed in all resorption areas, but complete repair was rarely found. No statistically significant difference was found between the BG and WG with regard to the ERR. No association was found between the root height position (middle or cervical third) and the incidence of ERR. Buccal root surfaces showed a higher amount of ERR compared with the palatal and interproximal surfaces. ERR was not found in any teeth in the CG. Conclusion:  All maxillary first premolars subjected to RME showed ERR and partial cementum repair. Banded teeth did not develop more ERR than nonbanded anchorage teeth.

scholarly journals An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube: A pilot study with rapid maxillary expansion

2021 ◽  
Author(s):  
Nihat Kılıç ◽  
Özgür Yörük ◽  
Songül Cömert Kılıç
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Rapid Maxillary Expansion ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Maxillary Expansion ◽  
Tube Dysfunction ◽  
Maxillary Constriction ◽  
Observation Period

ABSTRACT Objectives To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). Materials and Methods The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. Results In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P &gt; .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P &lt; .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). Conclusions The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.

scholarly journals Effects of rapid maxillary expansion on nasal mucociliary clearance

2015 ◽  
Vol 86 (2) ◽  
pp. 250-254
Author(s):  
Hasan Babacan ◽  
Cenk Doruk ◽  
Ismail Onder Uysal ◽  
Salim Yuce
Keyword(s):  
Orthodontic Treatment ◽  
Mucociliary Clearance ◽  
Systemic Disease ◽  
Rapid Maxillary Expansion ◽  
Control Group ◽  
Maxillary Expansion ◽  
Positive Effects ◽  
Significant Difference ◽  
Orthodontic Patients ◽  
Nasal Mucociliary Clearance

ABSTRACT Objective:  To evaluate the changes in nasal mucociliary clearance in orthodontic patients after rapid maxillary expansion (RME) therapy. Materials and Methods:  Forty-two children (25 boys and 17 girls) participated in this study. The RME group consisted of 21 patients (mean age, 13.8 years), who had undergone RME at the initiation of orthodontic treatment. The control group consisted of 21 subjects (mean age, 13.6 years), who were attending the department of orthodontics for active orthodontic treatment. The nasal mucociliary clearance was assessed by the saccharin test. Saccharin transit times (STTs) were measured for each treated subject before expansion (T1), after RME (T2), and after a 3-month retention period (T3). Records were obtained at the same time intervals for each group. Results:  The STT decreased significantly in the RME group after expansion and retention (P &lt; .05). A statistically significant difference was found when the STTs of the control and RME groups were compared after expansion and retention (P &lt; .05). Conclusions:  The STTs of young orthodontic patients with maxillary narrowness and without any history of nasal or systemic disease were within normal limits. However, RME increased the mucociliary clearance in patients who had maxillary narrowness, having positive effects on nasal physiology and increasing nasal cavity volume.

scholarly journals 3D mandibular positioning after rapid maxillary expansion in Class II malocclusion

2011 ◽  
Vol 22 (5) ◽  
pp. 428-434 ◽  
Author(s):  
Carolina Baratieri ◽  
Matheus Alves Jr ◽  
Eduardo Franzotti Sant’anna ◽  
Matilde da Cunha Gonçalves Nojima ◽  
Lincoln Issamu Nojima
Keyword(s):  
Lateral Displacement ◽  
Three Dimensional ◽  
Vertical Displacement ◽  
Class Ii ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Retention Period ◽  
Division 1 ◽  
Maxillary Constriction ◽  
Class Ii Division 1

This study investigated, using cone beam computed tomography (CBCT), the spatial mandibular positioning after rapid maxillary expansion (RME) in Class II Division 1 malocclusion. This prospective study evaluated 17 children (mean initial age 10.36 years old) presenting Class II, Division 1 malocclusion and skeletal maxillary constriction that underwent to RME Haas’ protocol. CBCT was performed before treatment (T1), immediately after the stabilization of expander screw (T2) and after the retention period of 6 months (T3). The scans were managed in Dolphin Imaging® 11.0 software, where landmarks (right and left condylion, right and left gonion, and menton) were positioned and measured in relation to sagittal, coronal and axial plane to verify, respectively, transverse, anteroposterior and vertical displacement of the mandible. Paired Student’s t-test was used to identify significant differences (p<0.05) between T1 and T2, T2 and T3, and T1 and T3. After RME, right and left gonion moved downward (1.11 mm and 0.89 mm) and menton displaced downward (1.90 mm) and backward (1.50 mm). During the retention period, only anteroposterior displacement was significant, with the right and left gonion (0.97 mm and 1.26 mm) and the menton (2.29 mm) moving forward. Three-dimensional assessment of the mandible in Class II Division 1 patients subjected to RME showed a transitory backward and downward mandibular positioning, without any lateral displacement. The 6-month retention period allowed the mandible shifting significantly forward, exhibiting a more anterior position compared with the initial condition, even remaining in a more downward direction.

scholarly journals Retrospective CBCT analysis of airway volume changes after bone-borne vs tooth-borne rapid maxillary expansion

2019 ◽  
Vol 89 (4) ◽  
pp. 566-574 ◽  
Author(s):  
Golnaz Kavand ◽  
Manuel Lagravère ◽  
Katherine Kula ◽  
Kelton Stewart ◽  
Ahmed Ghoneima
Keyword(s):  
Nasal Cavity ◽  
Three Dimensional ◽  
Upper Airway ◽  
Cone Beam ◽  
Maxillary Expansion ◽  
Retention Period ◽  
Maxillary Molars ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Cbct Analysis

ABSTRACT Objectives: To compare changes in upper airway volume after maxillary expansion with bone- and tooth-borne appliances in adolescents and to evaluate the dentoskeletal effects of each expansion modality. Materials and Methods: This retrospective study included 36 adolescents who had bilateral maxillary crossbite and received bone-borne maxillary expansion (average age: 14.7 years) or tooth-borne maxillary expansion (average age: 14.4 years). Subjects had two cone beam computed tomography images acquired, one before expansion (T1) and a second after a 3-month retention period (T2). Images were oriented, and three-dimensional airway volume and dentoskeletal expansion were measured. Analysis of variance was used to test for differences between the two expansion methods for pretreatment, posttreatment, and prepost changes. Paired t-tests were used to test for significance of prepost changes within each method. Results: Both groups showed significant increase only in nasal cavity and nasopharynx volume (P &lt; .05), but not oropharynx and maxillary sinus volumes. Intermolar and maxillary width increased significantly in both groups (P &lt; .05); however, the buccal inclination of maxillary molars increased significantly only in the tooth-borne group (P &lt; .05). There was no significant difference between tooth- and bone-borne expansion groups, except for the significantly larger increase in buccal inclination of the maxillary right first molar after tooth-borne expansion. Conclusions: In adolescents, both tooth- and bone-borne RME resulted in an increase in nasal cavity and nasopharynx volume, as well as expansion in maxillary intermolar and skeletal widths. However, only tooth-borne expanders caused significant buccal tipping of maxillary molars.

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