RME: effects on the nasal septum. A CBCT evaluation

Area of Science:

• Orthodontics and Craniofacial Development
• Pediatric Dentistry
• Medical Imaging

Background:

• Rapid maxillary expansion (RME) is an orthodontic technique used to widen the palate in growing children.
• Skeletal changes in the midface, particularly the maxillary complex and nasal septum, following RME require detailed investigation.
• Understanding these changes is crucial for assessing treatment efficacy and potential impacts on nasal airway function.

Purpose of the Study:

• To evaluate the three-dimensional changes in the maxillary complex and nasal septum after rapid maxillary expansion (RME) in growing children.
• To assess the impact of RME on nasal septum morphology, including deviation and length.
• To determine the effects of RME on the overall dimensions and growth of the maxillary complex.

Main Methods:

• Analysis of 3D imaging data from 39 children (aged 6.2-12.3 years) with pre-existing septal deviation (>1 mm).
• Comparison of cephalometric tracings at two time points: before RME (T0) and after expander removal (T1), with a 12-month interval.
• Evaluation of skeletal modifications, including piriform aperture width, nasal floor position, and septal deviation.

Main Results:

• Significant modification in nasal septum length, particularly in the lower third.
• Increase in piriform aperture width (1.58 mm) with lateral wall expansion and downward nasal floor movement.
• Reduction in septal deviation and no significant changes observed in a control group.

Conclusions:

• RME can positively influence nasal septum asymmetry in children.
• The procedure leads to increased nasal cavity volume via downward and forward movement, potentially improving breathing.
• RME promotes favorable maxillary complex growth and may reduce air resistance by laterally inclining the nasal cavity.