Three-dimensional computed tomography analysis of airway volume changes after rapid maxillary expansion

doi:10.1016/j.ajodo.2011.12.017

American Journal of Orthodontics and Dentofacial Orthopedics

Volume 141, Issue 5, May 2012, Pages 618-626

https://doi.org/10.1016/j.ajodo.2011.12.017 Get rights and content

Introduction

In this retrospective study with 3-dimensional computed tomography, we evaluated airway volume, soft-palate area, and soft-tissue thickness changes before and after rapid maxillary expansion in adolescents. Another purpose was to determine whether rapid maxillary expansion caused changes in the palatal and mandibular planes and facial height.

Methods

The sample comprised 20 patients who were treated with rapid maxillary expansion. Spiral tomographs were taken before and 3 months after treatment. Reliability studies were performed, and then volumetric, soft-palate area, soft-tissue thickness, and cephalometric parameters were compared on the tomographs. Intraclass correlations were performed on the reliability measurements. Before and after rapid maxillary expansion measurements were compared by using Wilcoxon signed rank tests. Spearman correlation coefficients were used to evaluate the associations among the airway volume, soft-palate area, soft-tissue thickness, and cephalometric measurements. Significance was accepted at P ≤0.05 for all tests.

Results

Intraclass correlation coefficients were ≥0.90 for all reliability measures. Significant increases from before to after rapid maxillary expansion were found in nasal cavity and nasopharynx volumes, and for the measurements of MP-SN, S-PNS, N-ANS, ANS-Me, and N-Me. Significant positive correlations existed between changes in PP-SN and N-ANS, and ANS-Me and N-Me.

Conclusions

Rapid maxillary expansion causes significant increases in nasal cavity volume, nasopharynx volume, anterior and posterior facial heights, and palatal and mandibular planes.

Section snippets

Material and methods

Pretreatment and posttreatment spiral computed tomography images (Xvision EX; Toshiba Medical Systems, Otawara-Shi, Japan) from 20 patients treated with RME were analyzed. The scans were made at 120 kV and 20 mA by using the following protocol: 25-cm field of view, 0.4-mm voxel size, and 2 seconds per section. The scans were taken with the patients in supine position and the palatal plane perpendicular to the floor.18, 19 The study was approved prospectively by the ethical committee of the

Results

The intraexaminer reliability test showed no statistically significant differences between the readings (except for PP-SN and ANS-Me) and excellent intraexaminer reliability (intraclass correlation coefficient, ≥0.90) for all measurements (Table II).

Comparisons between the before and after RME measurements showed statistically significant increases only in nasal cavity volume, nasopharynx volume, MP-SN, S-PNS, N-ANS, ANS-Me, and N-Me (Table III, Fig 8).

Significant positive correlations existed

Discussion

In this study, we evaluated the cephalometric parameters, airway volume, soft-palate area, and soft-tissue thickness changes before and after RME treatment using 3-dimensional images on the same set of adolescent subjects. Few studies have addressed treatment effects on the airway in the same patient population. RME is a common treatment approach for maxillary constriction, posterior crossbites, and arch length discrepancies, and is recommended to increase airway volume.23, 24, 25, 26, 27

Conclusions

RME causes significant increases in nasal cavity volume, nasopharynx volume, anterior and posterior facial heights, and palatal and mandibular planes.

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Rapid maxillary expansion (RME) expands the maxillary dentition laterally and improves nasal airway obstruction. However, the incidence of nasal airway obstruction improvement after RME is approximately 60%. This study aimed to clarify the beneficial effects of RME on nasal airway obstruction in specific pathologic nasal airway diseases (nasal mucosa hypertrophy and obstructive adenoids) using computer fluid dynamics.
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Original articleThree-dimensional computed tomography analysis of airway volume changes after rapid maxillary expansion

Introduction

Methods

Results

Conclusions

Section snippets

Material and methods

Results

Discussion

Conclusions

Am J Orthod Dentofacial Orthop

Am J Orthod

Am J Orthod Dentofacial Orthop

Int J Pediatr Otorhinolaryngol

Int J Pediatr Otorhinolaryngol

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

J Oral Maxillofac Surg

Am J Orthod Dentofacial Orthop

Am J Orthod

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

Am J Orthod

Original article
Three-dimensional computed tomography analysis of airway volume changes after rapid maxillary expansion