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Effects of Rapid Palatal Expansion on the Upper Airway Space in Children with Obstructive Sleep Apnea (OSA): A

Angela Galeotti1, Roberto Gatto2, Silvia Caruso2

  • 1Dentistry Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

Children (Basel, Switzerland)
|February 25, 2023
PubMed

Insights

Rapid palatal expansion (RPE) significantly increases upper airway dimensions and promotes counterclockwise mandibular growth in children with obstructive sleep apnea (OSA). This orthodontic intervention aids nasal breathing and supports OSA management.

Area of Science:

  • Orthodontics and Pediatric Sleep Medicine

Background:

  • Obstructive Sleep Apnea (OSA) in children requires a multidisciplinary approach.
  • Adenotonsillectomy is the primary treatment, but rapid palatal expansion (RPE) is an emerging adjunctive therapy.
  • Maxillary hypoplasia and posterior crossbite are common in pediatric OSA.

Purpose of the Study:

  • To evaluate cephalometric changes in upper airway dimensions following RPE in children with OSA.
  • To compare these changes to a control group of untreated children.
  • To assess the impact of RPE on mandibular growth direction.

Main Methods:

  • A pre-post study design involving 37 children (4-10 years) diagnosed with OSA.
  • Lateral cephalometric radiographs taken before (T0) and after (T1) RPE treatment.
  • A control group of 39 healthy children (4-11 years) was included for comparison.
  • Statistical analysis using paired T-tests to compare changes within and between groups.

Main Results:

  • RPE treatment resulted in a statistically significant increase in nasopharyngeal width.
  • A significant reduction in the mandibular divergence angle (PP-MP°) was observed post-RPE.
  • No significant cephalometric changes were noted in the untreated control group.

Conclusions:

  • RPE effectively increases sagittal space in the upper airways of children with OSA.
  • RPE promotes counterclockwise mandibular growth, potentially aiding nasal breathing.
  • Orthodontic interventions like RPE play a vital role in managing pediatric OSA.

Keywords:
cephalometrychildrenobstruction sleep apnearapid maxillary expanderupper airways

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