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

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.

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

The Angle Orthodontist ◽

10.2319/012313-71.1 ◽

2013 ◽

Vol 84 (2) ◽

pp. 265-273 ◽

Cited By ~ 52

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.

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Effects of rapid maxillary expansion on nasal mucociliary clearance

The Angle Orthodontist ◽

10.2319/121714-918.1 ◽

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 < .05). A statistically significant difference was found when the STTs of the control and RME groups were compared after expansion and retention (P < .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.

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Effects of rapid maxillary expansion on upper airway volume: A three-dimensional cone-beam computed tomography study

The Angle Orthodontist ◽

10.2319/101218-738.1 ◽

2019 ◽

Vol 89 (6) ◽

pp. 917-923 ◽

Cited By ~ 3

Author(s):

Yousef Abdalla ◽

Louise Brown ◽

Liselotte Sonnesen

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Matched Control ◽

Upper Airway ◽

Rapid Maxillary Expansion ◽

Skeletal Age ◽

Cone Beam ◽

Control Group ◽

Maxillary Expansion ◽

Pharyngeal Airway

ABSTRACT Objective: To compare changes in pharyngeal airway volume and minimal cross-sectional area (MCA) between patients undergoing rapid maxillary expansion (RME) and a matched control group and to identify markers for predicting airway changes using cone-beam computed tomography (CBCT). Materials and Methods: Pre- and posttreatment CBCT scans were selected of children who had RME (14 girls and 12 boys; mean age, 12.4 years) along with scans of a control group (matched for chronological age, skeletal age, gender, mandibular inclination) who underwent orthodontic treatment for minor malocclusions without RME. Changes in airway volume and MCA were evaluated using a standardized, previously validated method and analyzed by a mixed-effects linear regression model. Results: Upper airway volume and MCA increased significantly over time for both the RME and matched control groups (P < .01 and P = .05, respectively). Although the RME group showed a greater increase when compared with the matched controls, this difference was not statistically significant. A reduced skeletal age before treatment was a significant marker for a positive effect on the upper airway volume and MCA changes (P < .01). Conclusions: Tooth-borne RME is not associated with a significant change in upper airway volume or MCA in children when compared with controls. The younger the skeletal age before treatment, the more positive the effect on the upper airway changes. The results may prove valuable, especially in RME of young children.

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

The Angle Orthodontist ◽

10.2319/011015-20.1 ◽

2015 ◽

Vol 86 (1) ◽

pp. 39-45 ◽

Cited By ~ 3

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.

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

The Angle Orthodontist ◽

10.2319/021421-127.1 ◽

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 > .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 < .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.

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

BMC Oral Health ◽

10.1186/s12903-021-01488-1 ◽

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.

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

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-45.3.11 ◽

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.

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Short-term and long-term effects of rapid maxillary expansion on the nasal soft and hard tissue:

The Angle Orthodontist ◽

10.2319/022320-120.1 ◽

2020 ◽

Vol 91 (1) ◽

pp. 46-53

Author(s):

Cassie T. Truong ◽

Hyeran H. Jeon ◽

Puttipong Sripinun ◽

Ann Tierney ◽

Normand S. Boucher

Keyword(s):

Normal Growth ◽

Rapid Maxillary Expansion ◽

Control Group ◽

Long Term Effects ◽

Maxillary Expansion ◽

Hard Tissue ◽

Alar Base ◽

Significant Difference ◽

Term Evaluation

ABSTRACT Objectives To evaluate nasal soft and hard tissue changes immediately post–rapid maxillary expansion (RME) and to assess the stability of these changes using cone beam computed tomography (CBCT). Materials and Methods A total of 35 treatment group (TG) patients (18 girls, 17 boys; 9.39 ± 1.4) had a pre-RME CBCT and a post-RME CBCT approximately 66 days after expansion, and 25 patients had a follow-up CBCT 2.84 years later. A total of 28 control group (CG; no RME) patients (16 girls, 12 boys; 8.81 ± 1.6) had an initial CBCT and a CBCT an average of 2.25 years later. Soft and hard tissue nasal landmarks were measured in transverse, sagittal, and coronal planes of space on CBCT scans. Differences within the same group were evaluated by paired t-tests or Wilcoxon signed-rank tests. Long-term comparisons between TG and CG were evaluated by independent-sample t-tests or Wilcoxon rank-sum tests. Results Immediately post-RME, there were statistically significant mean increases of 1.6 mm of alar base width, 1.77 mm of pyriform height, and 3.57 mm of pyriform width (P < .05). CG showed the significant increases over 2.25 years (P < .001). Compared with CG, the long-term evaluation of TG demonstrated only pyriform height and pyriform width showed a statistically significant difference (P < .01). Conclusions Although RME produced some significant increase on the nasal soft tissue immediately after expansion, it regressed to the mean of normal growth and development over time. However, long-term evaluation of TG compared with CG showed only pyriform height and pyriform width to be affected by RME.

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

PLoS ONE ◽

10.1371/journal.pone.0261579 ◽

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.

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The evaluation of nasal mucociliary clearance in patients with Helicobacter pylori infection

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000136 ◽

2019 ◽

Vol 133 (03) ◽

pp. 220-223

Author(s):

S Üstün Bezgin ◽

T Çakabay ◽

K Irak ◽

M Koçyiğit ◽

B Serin Keskineğe ◽

...

Keyword(s):

Helicobacter Pylori ◽

Mucociliary Clearance ◽

Endoscopic Examination ◽

Control Group ◽

Clearance Time ◽

Saccharine Test ◽

Significant Difference ◽

And Gender ◽

H Pylori ◽

Nasal Mucociliary Clearance

AbstractObjectiveThis study aimed to examine nasal mucociliary clearance time in patients with Helicobacter pylori infection.MethodsFifty patients who were newly diagnosed with H pylori infection using gastric biopsy in the gastroenterology out-patient clinic, and 50 age- and gender-matched healthy adults who were admitted to the otorhinolaryngology out-patient clinic, were included in this study. After an otorhinolaryngological examination (anterior rhinoscopy and nasal endoscopic examination), the nasal mucociliary clearance time of each subject was calculated using the saccharine test.ResultsThe mean mucociliary clearance time was 06:29 ± 3:31 minutes (range, 00:55–15:19 minutes) in the control group and 10:12 ± 06:09 minutes (range, 01:28–32:00 minutes) in the study group. Comparisons of the two groups revealed a statistically significant difference (p = 0.002).ConclusionNasal mucociliary clearance time was significantly increased in patients with H pylori infection. The results suggest that H pylori infection may have an unfavourable effect on nasal mucociliary clearance.

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