Stress Response During Rapid Maxillary Expansion in Children

Area of Science:

• Orthodontics
• Pediatric Dentistry
• Endocrinology

Background:

• Rapid maxillary expansion (RME) is a common orthodontic procedure to correct transverse discrepancies.
• Understanding the physiological stress and inflammatory response during RME is crucial for patient management.
• Salivary biomarkers offer a non-invasive method to assess stress and inflammation.

Purpose of the Study:

• To evaluate the impact of RME on salivary cortisol (stress marker) and nitric oxide (inflammatory marker) levels.
• To compare the stress associated with the RME procedure versus the anticipation of dental visits.

Main Methods:

• Salivary samples were collected from 16 orthodontic patients undergoing RME at five time points.
• Cortisol and nitric oxide levels were measured using immunoassay kits and the Griess method, respectively.
• Statistical analysis included Friedman and Wilcoxon tests to assess changes over time and between groups.

Main Results:

• Cortisol levels showed significant changes over the study period, influenced by factors like appliance type (Haas), sex, age, and specific occlusal characteristics.
• Nitric oxide levels also changed significantly over time, particularly in patients using the Haas appliance, with higher levels at baseline compared to later time points.
• The waiting period before dental appointments (T3, T4) showed higher stress indicators than the RME procedure itself (T2, T4).

Conclusions:

• The anticipation of dental consultations appears to be more psychologically stressful for patients undergoing RME than the expansion procedure itself.
• Rapid maxillary expansion, as assessed by these salivary biomarkers, did not induce significant alterations related to inflammation.
• Specific patient characteristics and appliance types may influence the stress response during RME.