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Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid
Arzu Alan1, Mehmet Ugurlu2, İbrahim Sevki Bayrakdar3
1Ankara 75th Year Oral and Dental Health Hospital, Ministry of Health, Ankara 06230, Türkiye.
Insights
Rapid maxillary expansion (RME) in children improves airflow and ventilation in the nasal and pharyngeal airways. Computational fluid dynamics (CFD) effectively detects these ventilation improvements following orthodontic treatment.
Area of Science:
- Orthodontics
- Pediatric Dentistry
- Biomedical Engineering
Background:
- The impact of rapid maxillary expansion (RME) on pediatric nasal and pharyngeal airways requires further clarification.
- This study investigates RME's effects on airway ventilation using advanced computational methods.
Purpose of the Study:
- To assess changes in upper airway ventilation parameters after RME in children using computational fluid dynamics (CFD).
- To compare the efficacy of tooth-borne versus tooth-bone-borne RME techniques on airway morphology and ventilation.
Main Methods:
- Retrospective analysis of pre- and post-RME cone-beam computed tomography (CBCT) scans from 20 pediatric patients.
- CFD simulations were employed to analyze airflow dynamics (pressure, velocity) in the entire upper airway, nasal passages, and maxillary sinuses.
- Statistical comparisons were made for morphological and ventilatory parameters, with significance set at p < 0.05.
Main Results:
- RME treatment led to a significant reduction in airflow velocity and pressure within the upper airway (p < 0.05).
- Significant increases in nasal width, nasal cross-sectional area, intermolar width, and oropharyngeal airway width were observed post-RME (p < 0.05).
- No significant differences in ventilation changes were found between tooth-borne and tooth-bone-borne RME methods (p > 0.05).
Conclusions:
- Rapid maxillary expansion positively impacts childhood orthodontic issues by enhancing airflow and improving airway ventilation.
- Computational fluid dynamics (CFD) proves to be a valuable tool for quantifying ventilation improvements after RME.
Abstract:
Background/Objectives: The effect of rapid maxillary expansion (RME) on the nasal and pharyngeal airways in children remains uncertain. This retrospective study utilized computational fluid dynamics (CFD) to assess the changes in ventilation parameters caused by RME in children. Methods: Pre- and post-RME cone beam computed tomography (CBCT) images of 20 patients (4 males, mean age 13 ± 2 years) treated with RME for maxillary transverse insufficiency were evaluated. The RME treatment was conducted using two distinct techniques: tooth-borne and tooth-bone-borne. CFD simulations were used to investigate the airflow conditions (pressure and velocity) in the whole upper airway, nasal airway, and maxillary sinus. Morphological alterations and variations in ventilation parameters before and after RME treatment were statistically compared. The extent of changes in the morphological and ventilatory characteristics of the upper airway, depending on the type of RME, was assessed. Additionally, changes in the ventilation conditions of the upper airway, nasal airway, and maxillary sinus after RME treatment were statistically analyzed. Statistical analyses using IBM SPSS v22 (New York, USA) software included paired t-tests, Mann-Whitney U tests, Wilcoxon matched-pairs signed-rank tests, intraclass correlation coefficients, and coefficients of variation (p < 0.05). Results: The CFD study revealed a notable reduction in both air flow velocity and pressure after the RME treatment (p < 0.05). A statistically significant increase was seen in the parameters used to assess the morphological changes following RME treatment, including nasal width, anterior and posterior nasal cross-sectional area, intermaxillary and intermandibulary molar width, and oropharyngeal airway width (p < 0.05). Regarding the change in airway ventilation, there was no statistically significant difference between tooth-borne and tooth-bone-borne RME treatments (p > 0.05). Conclusions: RME not only treats orthodontic issues in childhood but also increases airflow, which enhances ventilation. CDF is an effective method for the detection of ventilation improvement.
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