Korean J Orthod.  2024 Jan;54(1):59-68. 10.4041/kjod23.090.

Long-term effects of maxillary skeletal expander treatment on functional breathing

• Combs A
• Paredes N
• Dominguez-Mompell R
• Romero-Maroto M
• Zhang B
• Elkenawy I
• Sfogliano L
• Fijany L
• Colak O
• Wu B
• Moon W

• KMID: 2551475
• DOI: http://doi.org/10.4041/kjod23.090

Abstract

Objective
To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing.
Methods
Objective measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). Results: Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. Conclusions: Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.

Keyword

Functional breathing; Microimplant-assisted rapid palatal expansion; Maxillary skeletal expander; Bone-anchored maxillary expander

Figure

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  Figure 1 The maxillary skeletal expander. A, Before expansion; B, after expansion and split of the midpalatal suture.

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  Figure 2 Visual analog scale (VAS). The left image shows the ruler used for the measurement of the VAS score. The right image shows an image representing the range of values on a VAS.

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  Figure 3 In-Check medical device. The left image shows the disassembled parts of the In-Check medical device. The right image shows the assembled In-Check medical device for peak nasal inspiratory flow (with nasal mask) and peak oral inspiratory flow measurements (with disposable oral mouthpiece).

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  Figure 4 The nasal obstruction symptom evaluation survey questions.

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  Figure 5 Cone beam computed tomography axial views demonstrating the magnitude of maxillary skeletal expander expansion, at level of anterior nasal spine, posterior nasal spine and zygomaticomaxillary point for right and left sides.

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