Effects of Rapid Maxillary Expander and Delaire Mask Treatment on Airway Sagittal Dimensions in Pediatric Patients Affected by Class III Malocclusion and Obstructive Sleep Apnea Syndrome

Overview

Journal Life (Basel)

Specialty Biology

Date 2023 Mar 29

PMID 36983829

Authors

Sara Caruso

Emanuela Lisciotto

Silvia Caruso

Alessandra Marino

Fabiana Fiasca

Marco Buttarazzi

David Sarzi Amade

Melania Evangelisti

Antonella Mattei

Roberto Gatto

Affiliations

Soon will be listed here.

Abstract

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that is very common in pediatric patients. In the literature, there are very few studies concerning the association between OSAS and class III malocclusion in children. The use of a rapid maxillary expander (RME) in association with the Delaire mask is a common treatment protocol for class III malocclusion. The aim of this work was to evaluate the cephalometric variations of upper airway dimensions and OSA-related clinical conditions after orthodontic treatment with an RME and the Delaire mask, as recorded in pediatric patients with a class III malocclusion who were affected by OSAS. In this preliminary study, 14 pediatric patients with mixed dentition, aged between 6 and 10 years, were selected. All patients were treated with an RME and the Delaire mask. Pre- and post-treatment cephalometric radiographs were traced, analyzed, and compared. The results demonstrated a significant increase in the upper airway linear measurements and the nasopharyngeal and oropharyngeal dimensions ( ≤ 0.05). This increase creates an improvement in airway patency and in OSAS-related clinical conditions. The use of the RME in association with the Delaire mask can be effective in the treatment of pediatric patients with a class III malocclusion who are affected by OSAS.

Citing Articles

Avoid overstepping the bounds of evidence: the role of the orthodontist in managing pediatric Obstructive Sleep Apnea.

Rinchuse D, Boggio A, Manni A, Cozzani M Front Oral Health. 2024; 5:1486573.

PMID: 39568789 PMC: 11576433. DOI: 10.3389/froh.2024.1486573.

Effects of Hyrax Maxillary Expander on Nasal Cavity and Upper Airway in Adolescents: A Systematic Review and Meta-Analysis.

Zhao Z, Cao R, Yao M, Liao C Healthcare (Basel). 2024; 12(21).

PMID: 39517360 PMC: 11544907. DOI: 10.3390/healthcare12212148.

Retrospective analysis of the upper airway anatomy and Sella turcica morphology across different skeletal malocclusions: a computerized technique.

Marya A, Inglam S, Dagnaud A, Wanchat S, Naronglerdrit P, Rithvitou H BMC Oral Health. 2024; 24(1):1110.

PMID: 39300479 PMC: 11411739. DOI: 10.1186/s12903-024-04867-6.

Evaluation of Orthodontic Treatment Modalities for Obstructive Sleep Apnoea: A Systematic Review.

Gorikapudi P, Chhabria V, Kaur K, Ramasamy P, Jeeboy S, Venkatesh R Cureus. 2024; 16(7):e65161.

PMID: 39176375 PMC: 11341081. DOI: 10.7759/cureus.65161.

Insights into Pediatric Sleep Disordered Breathing: Exploring Risk Factors, Surgical Interventions, and Physical and Scholastic Performance at Follow-Up.

Zaffanello M, Pietrobelli A, Zoccante L, Sacchetto L, Nosetti L, Piazza M Children (Basel). 2024; 11(4).

PMID: 38671605 PMC: 11049613. DOI: 10.3390/children11040388.

References

Mayer P, Pepin J, Bettega G, Veale D, Ferretti G, Deschaux C . Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients. Eur Respir J. 1996; 9(9):1801-9. DOI: 10.1183/09031936.96.09091801. View

Remy F, Bonnaure P, Moisdon P, Burgart P, Godio-Raboutet Y, Thollon L . Preliminary results on the impact of simultaneous palatal expansion and mandibular advancement on the respiratory status recorded during sleep in OSAS children. J Stomatol Oral Maxillofac Surg. 2020; 122(3):235-240. DOI: 10.1016/j.jormas.2020.07.008. View

Baccetti T, Franchi L, McNamara Jr J . Treatment and posttreatment craniofacial changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofacial Orthop. 2000; 118(4):404-13. DOI: 10.1067/mod.2000.109840. View

Kilinc A, Arslan S, Kama J, Ozer T, Dari O . Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in Class III malocclusion subjects. Eur J Orthod. 2007; 30(1):61-6. DOI: 10.1093/ejo/cjm076. View

Haas A . Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod. 1970; 57(3):219-55. DOI: 10.1016/0002-9416(70)90241-1. View

Giuca M, Pasini M, Caruso S, Tecco S, Necozione S, Gatto R . Index of orthodontic treatment need in obese adolescents. Int J Dent. 2015; 2015:876931. PMC: 4402187. DOI: 10.1155/2015/876931. View

Wisth P, Tritrapunt A, RYGH P, Boe O, Norderval K . The effect of maxillary protraction on front occlusion and facial morphology. Acta Odontol Scand. 1987; 45(3):227-37. DOI: 10.3109/00016358709098862. View

Pavoni C, Cretella Lombardo E, Lione R, Bollero P, Ottaviani F, Cozza P . Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion. Acta Otorhinolaryngol Ital. 2018; 37(6):479-485. PMC: 5782425. DOI: 10.14639/0392-100X-1420. View

Caprioglio A, Meneghel M, Fastuca R, Zecca P, Nucera R, Nosetti L . Rapid maxillary expansion in growing patients: correspondence between 3-dimensional airway changes and polysomnography. Int J Pediatr Otorhinolaryngol. 2013; 78(1):23-7. DOI: 10.1016/j.ijporl.2013.10.011. View

10.

Guilleminault C, Stoohs R . Chronic snoring and obstructive sleep apnea syndrome in children. Lung. 1990; 168 Suppl:912-9. DOI: 10.1007/BF02718227. View

11.

Yucel A, Unlu M, Haktanir A, Acar M, Fidan F . Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. AJNR Am J Neuroradiol. 2005; 26(10):2624-9. PMC: 7976204. View

12.

Turley P . Managing the developing Class III malocclusion with palatal expansion and facemask therapy. Am J Orthod Dentofacial Orthop. 2002; 122(4):349-52. DOI: 10.1067/mod.2002.127295. View

13.

Flores-Mir C, Korayem M, Heo G, Witmans M, Major M, Major P . Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and meta-analysis. J Am Dent Assoc. 2013; 144(3):269-77. DOI: 10.14219/jada.archive.2013.0113. View

14.

Bucci R, Montanaro D, Rongo R, Valletta R, Michelotti A, DAnto V . Effects of maxillary expansion on the upper airways: Evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2019; 46(4):377-387. DOI: 10.1111/joor.12766. View

15.

Villa M, Malagola C, Pagani J, Montesano M, Rizzoli A, Guilleminault C . Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12-month follow-up. Sleep Med. 2007; 8(2):128-34. DOI: 10.1016/j.sleep.2006.06.009. View

16.

Lione R, Brunelli V, Franchi L, Pavoni C, Souki B, Cozza P . Mandibular response after rapid maxillary expansion in class II growing patients: a pilot randomized controlled trial. Prog Orthod. 2017; 18(1):36. PMC: 5673058. DOI: 10.1186/s40510-017-0189-6. View

17.

Brouilette R, Hanson D, David R, Klemka L, Szatkowski A, Fernbach S . A diagnostic approach to suspected obstructive sleep apnea in children. J Pediatr. 1984; 105(1):10-4. DOI: 10.1016/s0022-3476(84)80348-0. View

18.

Villa M, Brunetti L, Bruni O, Cirignotta F, Cozza P, Donzelli G . [Guidelines for the diagnosis of childhood obstructive sleep apnea syndrome]. Minerva Pediatr. 2004; 56(3):239-53. View

19.

Hoekema A, Hovinga B, Stegenga B, de Bont L . Craniofacial morphology and obstructive sleep apnoea: a cephalometric analysis. J Oral Rehabil. 2003; 30(7):690-6. DOI: 10.1046/j.1365-2842.2003.01130.x. View

20.

Ferrazzano G, Orlando S, Cantile T, Sangianantoni G, Alcidi B, Coda M . An experimental in vivo procedure for the standardised assessment of sealants retention over time. Eur J Paediatr Dent. 2016; 17(3):176-180. View