Abstract
Midpalatal corticotomy-assisted rapid maxillary expansion (MCRME) is a minimally invasive treatment of maxillary transverse deficiency (MTD) in young adults. However, the effect of MCRME on respiratory function still needs to be determined. In this study, we evaluated the changes in maxillary morphology and the upper airway following MCRME using computational fluid dynamics (CFD). Twenty patients with MTD (8 males, 12 females; mean age 20.55 years) had cone-beam computed tomography (CBCT) images taken before and after MCRME. The CBCT data were used to construct a three-dimensional (3D) upper airway model. The upper airway flow characteristics were simulated using CFD, and measurements were made based on the CBCT images and CFD. The results showed that the widths of the palatal bone and nasal cavity, and the intermolar width were increased significantly after MCRME. The volume of the nasal cavity and nasopharynx increased significantly, while there were no obvious changes in the volumes of the oropharynx and hypopharynx. CFD simulation of the upper airway showed that the pressure drop and maximum velocity of the upper airway decreased significantly after treatment. Our results suggest that in these young adults with MTD, increasing the maxillary width, upper airway volume, and quantity of airflow by MCRME substantially improved upper airway ventilation.
概要
目的
采用三维重建技术及流体动力学探究上颌宽度不足的年轻成人经腭中缝骨皮质切开辅助快速扩弓 (MCRME) 后上颌宽度、 上气道形态和功能的变化及治疗效果.
创新点
应用三维重建技术及流体动力学评估 MCRME 对上气道的通气状况的影响
方法
本研究选择 20 例上颌宽度不足年轻成人患者作为研究对象, 并分别于矫治前和 MCRME 治疗三个月后拍摄锥形束 CT (CBCT), 对其进行三维重建及流体动力学分析, 比较矫正前后鼻腔宽度、 上颌牙弓宽度、 上颌基骨宽度、 上气道体积、 气流压降和速度的变化.
结论
上颌宽度不足的年轻成人采用 MCRME 矫正后上颌宽度扩大, 鼻腔和鼻咽部上气道的体积增加, 并且上气道内的气流速度减缓, 气流阻力下降, 上气道的通气状况整体改善.
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Acknowledgments
The research is supported by the National Natural Science Foundation of China (No. 81970978), the Zhejiang Provincial Natural Science Foundation of China (No. LQ18H140004), and the Zhejiang Provincial Medical Health & Hygienic Science and Technology Project of China (Nos. 2018KY365, 2019RC156, and 2020KY449).
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Juan LI designed the study. Lingfang SHI collected the data. Xiayao ZHANG, Luxi WENG, and Hong CHEN performed the data processing and data analysis. Juan LI, Lingfang SHI, and Jun LIN wrote and edited the manuscript. All authors have edited and approved the final manuscript, and they have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Juan LI, Lingfang SHI, Xiayao ZHANG, Luxi WENG, Hong CHEN, and Jun LIN declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study. Additional informed consent was obtained from all patients for which identifying information is included in this article.
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Li, J., Shi, L., Zhang, X. et al. Evaluating the effect of midpalatal corticotomy-assisted rapid maxillary expansion on the upper airway in young adults using computational fluid dynamics. J. Zhejiang Univ. Sci. B 22, 146–155 (2021). https://doi.org/10.1631/jzus.B2000090
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DOI: https://doi.org/10.1631/jzus.B2000090
Key words
- Maxillary transverse deficiency (MTD)
- Rapid maxillary expansion (RME)
- Upper airway
- Computational fluid dynamics (CFD)