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05.07.2022 | Sleep Breathing Physiology and Disorders • Original Article

Polygraphic evaluation of the effects of different rapid maxillary expansion appliances on sleep quality: A randomized clinical trial

verfasst von: Gokcenur Gokce, Ozen K. Basoglu, Ilknur Veli

Erschienen in: Sleep and Breathing | Ausgabe 2/2023

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Abstract

Background

The purpose of this clinical study was to assess the effects of different rapid maxillary expansion appliances on the severity of obstructive sleep apnea (OSA).

Material and methods

Patients having a narrow maxilla and identified with OSA were divided randomly into three groups: tooth tissue-borne, tooth-borne, and bone-borne expanders. Changes in sleep parameters at baseline and 3-month follow-up detected by polygraphy were the primary outcome. Treatment of the crossbite was the secondary outcome. Dunn-Bonferroni tests, Kruskal–Wallis, and Wilcoxon analysis were applied for intra- and inter-group differences at p < 0.05 significance level.

Results

Among 46 patients randomized, apnea-hypopnea index (AHI) changed from baseline to follow-up in all groups (− 1.6, p = 0.280; 0.6, p = 0.691; − 0.45, p = 0.796, respectively), with no between-group difference (p = 0.631). Oxygen desaturation index (ODI) altered from baseline to follow-up in all groups (0.80, p = 0.977; 0.20, p = 0.932; and − 1.00, p = 0.379, respectively), with no between-group difference (p = 0.858). There was no significant difference in minimum oxygen saturation from baseline to follow-up in all groups (0.00, p = 0.401; − 2.00, p = 0.887; 0.50, p = 0.407, respectively). No significant changes were observed in supine AHI from baseline to follow-up in all groups (0.00, p = 0.581; − 1.00, p = 0.393; 0.00, p = 0.972, respectively). The upper intermolar width increased from baseline to follow-up in all groups (5.04, p = 0.000; 3.15, p = 0.001; 5.41, p = 0.00, respectively) with no between-group difference (p = 0.560). Maxillary width increased from baseline to follow-up in all groups (4.25, p = 0.001; 4.74, p = 0.00; 4.49, p = 0.001, respectively) with no inter-group difference (p = 0.963).

Conclusions

The amount of skeletal and dental expansion obtained in the maxilla was similar in all groups. Rapid maxillary expansion was not found to be effective in OSA treatment.

Trial registration

ClinicalTrials.gov Identifier: NCT04604392.

Nieto FJ, Young TB, Lind BK et al (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study JAMA 283:1829–1836. https://doi.org/10.1001/jama.283.14.1829CrossRefPubMed

Carroll JL (2003) Obstructive sleep-disordered breathing in children: new controversies, new directions. Clin Chest Med 24:261–282. https://doi.org/10.1016/s0272-5231(03)00024-8CrossRefPubMed

Katyal V, Pamula Y, Daynes CN et al (2013) Craniofacial and upper airway morphology in pediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansion. Am J Orthod Dentofacial Orthop 144:860–871. https://doi.org/10.1016/j.ajodo.2013.08.015CrossRefPubMed

Cistulli PA (1996) Craniofacial abnormalities in obstructive sleep apnoea: implications for treatment. Respirology 1(3):167–174. https://doi.org/10.1111/j.1440-1843.1996.tb00028.xCrossRefPubMed

Cistulli PA, Palmisano RG, Poole MD (1998) Treatment of obstructive sleep apnea syndrome by rapid maxillary expansion. Sleep 21:831–835. https://doi.org/10.1093/sleep/21.8.831CrossRefPubMed

Löfstrand-Tideström B, Thilander B, Ahlqvist-Rastad J et al (1999) Breathing obstruction in relation to craniofacial and dental arch morphology in 4-year-old children. Eur J Orthod 21(4):323–332. https://doi.org/10.1093/ejo/21.4.323CrossRefPubMed

Camacho M, Chang ET, Song SA et al (2017) Rapid maxillary expansion for pediatric obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope 127:1712–1719. https://doi.org/10.1002/lary.26352CrossRefPubMed

Miano S, Rizzoli A, Evangelisti M et al (2009) NREM sleep instability changes following rapid maxillary expansion in children with obstructive apnea sleep syndrome. Sleep Med 10:471–478. https://doi.org/10.1016/j.sleep.2008.04.003CrossRefPubMed

Pirelli P, Saponara M, Guilleminault C (2004) Rapid maxillary expansion in children with obstructive sleep apnea syndrome. Sleep 27:761–766. https://doi.org/10.1093/sleep/27.4.761CrossRefPubMed

10.

Villa MP, Malagola C, Pagani J, Montesano M et al (2007) Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12-month follow-up. Sleep Med 8:128–134. https://doi.org/10.1016/j.sleep.2006.06.009CrossRefPubMed

11.

Ghoneima A, Abdel-Fattah E, Hartsfield J, El-Bedwehi A, Kamel A, Kula K (2011) Effects of rapid maxillary expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop 140:510–519. https://doi.org/10.1016/j.ajodo.2010.10.024CrossRefPubMedPubMedCentral

12.

Caldas LD, Takeshita WM, Machado AW, Bittencourt MAV (2020) Effect of rapid maxillary expansion on nasal cavity assessed with cone-beam computed tomography. Dental Press J Orthod 25:39–45. https://doi.org/10.1590/2177-6709.25.3.039-045.oarCrossRefPubMedPubMedCentral

13.

Cortella S, Shofer FS, Ghafari J (1997) Transverse development of the jaws: norms for the posteroanterior cephalometric analysis. Am J Orthod Dentofacial Orthop 112:519–522. https://doi.org/10.1016/S0889-5406(97)70079-9CrossRefPubMed

14.

Garib DG, Henriques JF, Janson G et al (2006) Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and toothborne expanders: a computed tomography evaluation. Am J Orthod Dentofac Orthop 129:749–758. https://doi.org/10.1016/j.ajodo.2006.02.021CrossRef

15.

Watson WG (1980) Expansion and fenestration or dehiscence. Am J Orthod 77:330–332. https://doi.org/10.1016/0002-9416(80)90086-xCrossRefPubMed

16.

Samandara A, Papageorgiou SN, Ioannidou-Marathiotou I et al (2018) Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis. Eur J Orthod 41(1):67–79. https://doi.org/10.1093/ejo/cjy027 [Epub ahead of print]

17.

Garib DG, Henriques JF, Janson G et al (2005) Rapid maxillary expansion – tooth tissue-borne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects. Angle Orthod 75:548–557. https://doi.org/10.1043/0003-3219(2005)75[548:RMETVT]2.0.CO;2CrossRefPubMed

18.

Lagravère MO, Carey J, Heo G, Toogood RW, Major PW (2010) Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop 137:304–305. https://doi.org/10.1016/j.ajodo.2009.09.016CrossRef

19.

Moher D, Schulz KF, Altman D, Consort Group (2001) The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA 285:1987–1991. https://doi.org/10.7326/0003-4819-134-8-200104170-00011CrossRef

20.

Moraleda-Cibrián M, Edwards SP, Kasten SJ et al (2015) Obstructive sleep apnea pretreatment and posttreatment in symptomatic children with congenital craniofacial malformations. J Clin Sleep Med 11(1):37–43. https://doi.org/10.5664/jcsm.4360CrossRefPubMedPubMedCentral

21.

Tomlinson DJ, Erskine RM, Morse CI, Onambélé GL (2019) Body fat percentage, body mass index, fat mass index and the ageing bone: their singular and combined roles linked to physical activity and diet. Nutrients 11:195. https://doi.org/10.3390/nu11010195CrossRefPubMedPubMedCentral

22.

Springate SD (2012) The effect of sample size and bias on the reliability of estimates of error: a comparative study of Dahlberg’s formula. Eur J Orthod 34:158–163. https://doi.org/10.1093/ejo/cjr010CrossRefPubMed

23.

Carter R 3rd, Watenpaugh DE (2008) Obesity and obstructive sleep apnea: or is it OSA and obesity? Pathophysiology 15(2):71–77. https://doi.org/10.1016/j.pathophys.2008.04.009CrossRefPubMed

24.

Noussios G, Skouras A, Chouridis P, Argyriou N, Gougousis S, Kontzoglou G (2008) The use of acoustic rhinometry for the assessment of adenoid hypertrophy: a clinical study. Acta Otorrinolaringol Eng 59:433–437. https://doi.org/10.1016/S0001-6519(08)75114-8CrossRef

25.

Wolfson AR, Carskadon MA (1998) Sleep schedules and daytime functioning in adolescents. Child Dev 69:875–887. https://doi.org/10.1111/j.1467-8624.1998.tb06149.xCrossRefPubMed

26.

Villa MP, Rizzoli A, Rabasco J, Vitelli O, Pietropaoli N, Cecili M, Malagola C (2015) Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children. Sleep Med 16:709–716. https://doi.org/10.1016/j.sleep.2014.11.019CrossRefPubMed

27.

Chung CH, Font B (2004) Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofacial Orthop 126:569–575CrossRefPubMed

28.

Hino CT, Pereira MD, Sobral CS, Kreniski TM, Ferreira LM (2008) Transverse effects of surgically assisted rapid maxillary expansion: a comparative study using Haas and Hyrax. J Craniofac Surg 19:718–725CrossRefPubMed

29.

Perillo L, De Rosa A, laselli F, d’Apuzzo F, Grassia V, Cappabianca S (2014) Comparison between rapid and mixed maxillary expansion through an assessment of den- to-skeletal effects on posteroanterior cephalometry. Prog Orthod 15:46

30.

Kayalar E, Schauseil M, Kuvat SV, Emekli U, FıratlıS, (2016) Comparison of tooth-borne and hybrid devices in surgically assisted rapid maxillary expansion: a randomized clinical cone-beam computed tomography study. J Craniomaxillofac Surg 44:285–93CrossRefPubMed

31.

Caprioglio A, Meneghel M, Fastuca R, Zecca PA, Nucera R, Nosetti L (2014) Rapid maxillary expansion in growing patients: correspondence between 3-dimensional airway changes and polysomnography. Int J Pediatr Otorhinolaryngol 78:23–27. https://doi.org/10.1016/j.ijporl.2013.10.011CrossRefPubMed

32.

Fastuca R, Perinetti G, Zecca PA, Nucera R, Caprioglio A (2015) Airway compartments volume and oxygen saturation changes after rapid maxillary expansion: a longitudinal correlation study. Angle Orthod 85:955–961. https://doi.org/10.2319/072014-504.1CrossRefPubMedPubMedCentral

33.

Palmisano RG, Wilcox I, Sullivan CE, Cistulli PA (1996) Treatment of snoring and obstructive sleep apnoea by rapid maxillary expansion. Aust N Z J Med 26:428–429. https://doi.org/10.1111/j.1445-5994.1996.tb01941.xCrossRefPubMed

34.

Taddei M, Alkhamis N, Tagariello T, D’Alessandro G, Mariucci EM, Piana G (2015) Effects of rapid maxillary expansion and mandibular advancement on upper airways in Marfan’s syndrome children: a home sleep study and cephalometric evaluation. Sleep Breath 19:1213–1220. https://doi.org/10.1007/s11325-015-1141-yCrossRefPubMed

35.

Dave Singh G, Callister JD (2013) Effect of a maxillary appliance in an adult with obstructive sleep apnea: a case report. Cranio 31:171–175. https://doi.org/10.1179/crn.2013.027CrossRefPubMed

36.

Rose E, Schessl J (2006) Orthodontic procedures in the treatment of obstructive sleep apnea in children. J Orofac Orthop 67:58–67. https://doi.org/10.1007/s00056-006-0534-8CrossRefPubMed

37.

Vinha PP, Eckeli AL, Faria AC, Xavier SP, de Mello-Filho FV (2016) Effects of surgically assisted rapid maxillary expansion on obstructive sleep apnea and daytime sleepiness. Sleep Breath 20:501–508. https://doi.org/10.1007/s11325-015-1214-yCrossRefPubMed

38.

Ashok N, Varma NS, Ajith VV, Gopinath S (2014) Effect of rapid maxillary expansion on sleep characteristics in children. Contemp Clin Dent 5:489–494. https://doi.org/10.4103/0976-237X.142817CrossRefPubMedPubMedCentral

Titel: Polygraphic evaluation of the effects of different rapid maxillary expansion appliances on sleep quality: A randomized clinical trial
verfasst von: Gokcenur Gokce
Ozen K. Basoglu
Ilknur Veli
Publikationsdatum: 05.07.2022
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 2/2023
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-022-02677-0

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Polygraphic evaluation of the effects of different rapid maxillary expansion appliances on sleep quality: A randomized clinical trial

Abstract

Background

Material and methods

Results

Conclusions

Trial registration

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Abstract

Background

Material and methods

Results

Conclusions

Trial registration

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