EC Dental Science

Research Article Volume 22 Issue 7 - 2023

Evaluation of Skeletal and Airway Volumetric Changes After Rapid Maxillary Expansion in Children Suffering from OSA - A Three-Dimensional Study

Kritika Kanwar Butta1*, Utsavraj Butta2, Sanjeevani Ratti3 and Priyanka Basu4

1Department of Prosthodontics, TMJ and Dental Sleep Medicine, Dental World Superspeciality Clinics Pvt. Limited, West Bengal, India
2Department of Oral and Maxillofacial Surgery and Oral Implantology, Dental World Superspeciality Clinics Pvt. Limited, West Bengal, India
3Department of Orthodontics, Dental World Superspeciality Clinics Pvt. Limited, West Bengal, India
4Department of Periodontics, Dental World Superspeciality Clinics Pvt. Limited, West Bengal, India

*Corresponding Author: Kritika Kanwar Butta, Department of Prosthodontics, TMJ and Dental Sleep Medicine, Dental World Superspeciality Clinics Pvt. Limited, West Bengal, India.
Received: June 15, 2023; Published: June 28, 2023



Introduction: Maxillary transverse deficiency (MTD) is a pathologic condition frequently seen associated with different malocclusions. Patients with MTD usually have increased nasal resistance, and unfavourable tongue and hyoid bone position, and are predisposed to breathing disorders. Rapid Maxillary Expansion (RME) may increase airway dimensions, and improve breathing and is an effective procedure to correct maxillary deficiency.

Aim: The aim of this study was to evaluate the changes in maxillary width and upper airway spaces in growing children with maxillary transverse deficiency (MTD) after rapid palatal expansion.

Materials and Methods: Five patients (1 male, 4 females; mean age 10.8) with maxillary transverse deficiency were recruited. An expander was placed on D, E and first permanent molars. Cone beam computed tomography was performed before treatment and at the end of the active expansion phase. Measurements were done on the basis of the cone beam computed tomography images by using Romexis 3-D software. Descriptive statistical analysis was performed to calculate the means with corresponding standard deviations (s.d.). t-test was used to compare means. Pearson’s correlation coefficient was calculated to find the correlation between the two variables. p < 0.

Result: In all the cases the values of the parameters were increased after treatment as compared to before treatment but these were not significant (p > 0.05). After treatment, both Nasal Width and Transverse palatal width showed positive and significant correlations with airway volume. Thus, airway volume increased significantly with the increase in Nasal Width and Transverse palatal width (p < 0.05).

Conclusion: Widening of transverse maxillary deficiency after rapid palatal expansion with orthodontic therapy improves upper airway spaces in growing children.

Keywords: Rapid Maxillary Expansion (RME); Obstructive Sleep Apnea (OSA); Sleep-Disordered Breathing (SDB); OSA-18 Quality of Life Survey; Pediatric Sleep Questionnaire; STOP-BANG Questionnaire; CBCT

  1. Eckert DJ and Malhotra A. “Pathophysiology of adult obstructive sleep apnea”. Proceedings of the American Thoracic Society 2 (2008): 144-153.
  2. Cielo CM and Marcus CL. “Obstructive sleep apnoea in children with craniofacial syndromes”. Paediatric Respiratory Reviews 3 (2015): 189-196.
  3. Tsukada E., et al. “Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness”. PLoS One 10 (2018): 0-12.
  4. Lee YH., et al. “Craniofacial, dental arch morphology, and characteristics in preschool children with mild obstructive sleep apnea”. Journal of Dental Sciences 2 (2020): 193-199.
  5. Timms DJ. “The reduction of nasal airway resistance by rapid maxillary expansion and its effect on respiratory disease”. The Journal of Laryngology and Otology 4 (1984): 357-362.
  6. Haas AJ. “Palatal expansion: Just the beginning of dentofacial orthopedics”. American Journal of Orthodontics and Dentofacial Orthopedics 3 (1970): 219-255.
  7. Adkins MD., et al. “Arch perimeter changes on rapid palatal expansion”. American Journal of Orthodontics and Dentofacial Orthopedics 3 (1990): 194-199.
  8. Baccetti T., et al. “Treatment Timing for Rapid Maxillary Expansion”. The Angle Orthodontist 5 (2001): 343-350.
  9. Boucher G. “Book Reviews: Book Reviews”. Critical Sociology 4 (2011): 493-497.
  10. Los UMDECDE. No No Covariance structure analysis of health-related indicators in elderly people at home with a focus on subjective health.
  11. Pirelli P., et al. “Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: A 12-year follow-up”. Sleep Medicine 8 (2015): 933-935.
  12. Villa MP., et al. “Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up”. Sleep Breath 2 (2011): 179-184.
  13. Marino A., et al. “Rapid maxillary expansion in children with Obstructive Sleep Apnoea Syndrome (OSAS)”. European Journal of Paediatric Dentistry: EJPD1 (2012): 57-63.
  14. Villa MP., et al. “Adenotonsillectomy and orthodontic therapy in pediatric obstructive sleep apnea”. Sleep Breath 18 (2014): 533-539.
  15. Matsumoto MAN., et al. “Long-term effects of rapid maxillary expansion on nasal area and nasal airway resistance”. The American Journal of Rhinology and Allergy 2 (2010): 161-165.
  16. Abdalla Y., et al. “Effects of rapid maxillary expansion on upper airway volume: A three-dimensional cone-beam computed tomography study”. The Angle Orthodontist 6 (2019): 917-923.
  17. Ceroni Compadretti G., et al. “Acoustic rhinometric measurements in children undergoing rapid maxillary expansion”. International Journal of Pediatric Otorhinolaryngology 1 (2006): 27-34.
  18. Compadretti GC., et al. “Nasal airway measurements in children treated by rapid maxillary expansion”. American Journal of Rhinology and Allergy 4 (2006): 385-393.
  19. Langer MRE., et al. “Does rapid maxillary expansion increase nasopharyngeal space and improve nasal airway resistance?” International Journal of Pediatric Otorhinolaryngology 1 (2011): 122-125.
  20. Iwasaki T., et al. “Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion: A cone-beam computed tomography study”. American Journal of Orthodontics and Dentofacial Orthopedics 2 (2013): 235-245.
  21. Baratieri C., et al. “Does rapid maxillary expansion have long-term effects on airway dimensions and breathing?” American Journal of Orthodontics and Dentofacial Orthopedics 2 (2011): 146-156.
  22. Chervin RD., et al. “Pediatric sleep questionnaire (PSQ): Validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems”. Sleep Medicine 1 (2000): 21-32.
  23. “Age changes of jaws and soft tissue profile”. The Scientific World Journal (2014).
  24. Katyal V., et al. “Craniofacial and upper airway morphology in pediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansion”. American Journal of Orthodontics and Dentofacial Orthopedics 6 (2013): 860-871.
  25. Cozzani M., et al. “Deciduous dentition-anchored rapid maxillary expansion in crossbite and non-crossbite mixed dentition patients: reaction of the permanent first molar”. Progress in Orthodontics 4 (2003): 15-22.
  26. Villa MP., et al. “Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children”. Sleep Medicine 6 (2015): 709- 716.
  27. Ilizarov GA. “The Tension-Stress Effect on the Genesis and Growth of Tissues”. Clinical Orthopaedics and Related Research 239 (1989): 263-285.
  28. Lagravère MO., et al. “Rapid Maxillary Expansion Treatment”. Journal of the American Dental Association 1 (2006): 44-53.
  29. Greenlee GM. “Rapid Maxillary Expansion Results Primarily in Dental, not Skeletal, Changes”. Journal of Evidence-Based Dental Practice 1 (2007): 17-18.
  30. Akkaya S., et al. “A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures”. European Journal of Orthodontics 2 (1999): 175-180.
  31. Thiradilok S. Changes in Dental Arch Dimension among Dental Class II Patients after Rapid Maxillary Expansion Therapy (2008).
  32. Oliveira De Felippe NL., et al. “Relationship between rapid maxillary expansion and nasal cavity size and airway resistance: Short- and long-term effects”. American Journal of Orthodontics and Dentofacial Orthopedics 3 (2008): 370-382.
  33. Zhao Y., et al. “Oropharyngeal airway changes after rapid palatal expansion evaluated with cone-beam computed tomography”. American Journal of Orthodontics and Dentofacial Orthopedics . 4 (2010): S71-S78.
  34. Chen G., et al. “Stable region for maxillary dental cast superimposition in adults, studied with the aid of stable miniscrews”. Orthodontics and Craniofacial Research 2 (2011): 70-79.
  35. Saadeh M., et al. “Instability of palatal rugae following rapid maxillary expansion”. European Journal of Orthodontics 5 (2017): 474-481.
  36. Parakkal T., et al. “Long-term Effects of Rapid Palatal Expansion on Airway and Nasal Cavity Using Three-dimensional Analysis: A Systematic Review”. World Journal of Dentistry 2 (2023): 182-191.
  37. Pia M., et al. “Rapid maxillary expansion in children with Obstructive Sleep Apnoea Syndrome (OSAS)”. Sleep Medicine 1 (2017): 1053-1061.
  38. Bahammam SA. “Rapid Maxillary Expansion for Obstructive Sleep Apnea among children - Systematic Review and Meta-analysis”. Sleep Science. Brazilian Association of Sleep and Latin American Federation of Sleep Societies 13 (2020): 70-77.
  39. Berger JL., et al. “Stability of orthopedic and surgically assisted rapid palatal expansion over time”. American Journal of Orthodontics and Dentofacial Orthopedics 6 (1998): 638-645.
  40. Cordasco G., et al. “Efficacy of orthopedic treatment with protraction facemask on skeletal Class III malocclusion: A systematic review and meta-analysis”. Orthodontics and Craniofacial Research 3 (2014): 133-143.
  41. Digregorio MV., et al. “Buccal bone plate thickness after rapid maxillary expansion in mixed and permanent dentitions”. American Journal of Orthodontics and Dentofacial Orthopedics 2 (2019): 198-206.
  42. Niu X., et al. “Three-dimensional analyses of short- and long-term effects of rapid maxillary expansion on nasal cavity and upper airway: A systematic review and meta-analysis”. Orthodontics and Craniofacial Research 3 (2020): 250-276.
  43. ElH and Palomo JM. “Three-dimensional evaluation of upper airway following rapid maxillary expansion A CBCT study”. The Angle Orthodontist 2 (2014): 265-273.
  44. Giannasi LC., et al. “Effect of a rapid maxillary expansion on snoring and sleep in children: A pilot study”. The Journal of Craniomandibular and Sleep Practice 3 (2015): 169-173.
  45. Ortu E., et al. “Oropharyngeal airway changes after rapid maxillary expansion: The state of the art”. International Journal of Clinical and Experimental Medicine 7 (2014): 1632-1638.

Kritika Kanwar Butta., et al. "Evaluation of Skeletal and Airway Volumetric Changes After Rapid Maxillary Expansion in Children Suffering from OSA - A Three-Dimensional Study". EC Dental Science 22.7 (2023): 101-112.

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