Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography...

Area of Science:

• Orthodontics
• Craniofacial Surgery
• Pediatric Dentistry

Background:

• Unilateral cleft lip and palate (UCLP) often present with transverse maxillary deficiency.
• Effective maxillary expansion is crucial for improving facial aesthetics and function in UCLP patients.
• Different rapid maxillary expansion (RME) devices vary in their efficacy for specific anatomical changes.

Purpose of the Study:

• To compare the effectiveness of four RME devices (Hyrax, Fan-Type, iMini-M, iMini-B) in UCLP patients.
• To evaluate changes in maxillary width, nasal volume, and oropharyngeal dimensions post-expansion.
• To determine which RME device offers optimal outcomes for UCLP treatment.

Main Methods:

• A cohort of 40 UCLP patients with transverse maxillary deficiency underwent RME.
• Patients were divided into four groups based on the expander used: Hyrax, Fan-Type, inverted mini-hyrax on molars (iMini-M), or inverted mini-hyrax on premolars (iMini-B).
• Cone-beam computed tomography (CBCT) scans were acquired pre- and post-expansion (3 months), analyzed using ANOVA and t-tests.

Main Results:

• All expanders significantly increased anterior maxillary width; no intergroup differences were observed.
• The iMini-B group showed no significant increase in posterior maxillary width.
• Hyrax and iMini-M demonstrated the greatest posterior expansion. Only Hyrax and iMini-M significantly increased nasal passage volume, with significant intergroup differences noted between Fan-Type and iMini-M.
• No expander significantly altered oropharyngeal dimensions.

Conclusions:

• The Hyrax and iMini-M expanders are most effective for improving nasal passage volume in UCLP patients.
• None of the evaluated RME devices significantly impacted oropharyngeal airway dimensions.
• Device selection for RME in UCLP should consider the goal of nasal airway enhancement.