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Published on: October 20, 2023
Volumetric airway changes in adolescents treated with mini-screw assisted rapid palatal expansion (MARPE)
R Nithin Vaishag1, Sapna Varma N K1, Renuka Balu2
1Department of Orthodontics and Dentofacial Orthopedics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India, 682041.
Objective:
Reduced airway dimensions of the upper pharynx due to transverse maxillary deficiency has a prevalence of 18 % among young adults. Bone anchored palatal expansion with miniscrew assisted rapid maxillary expansion (MARPE) appliance has expanded the envelope of treatment options available to treat maxillary constriction in adolescents and young adults. The purpose of the study was to evaluate the volumetric changes in airway dimensions following MARPE and to correlate clinical airway changes using flexible nasopharyngoscopy.
Methods:
Ten adolescents (aged 15-20 years) with transverse maxillary deficiency satisfying the inclusion criteria were selected for the study and treated with MARPE. The changes with MARPE in dental, skeletal, and airway dimensions were evaluated clinically and radiographically with flexible nasopharyngoscopy and cone-beam computed tomography (CBCT) respectively. The volumetric changes were compared using paired sample t-test and the change in airway collapse was compared using Pearson Chi-square test.
Results:
A significant increase in intermolar distance, interpremolar distance, maxillary inter-buccal and inter-lingual distance, molar bucco-lingual angulation, nasopharyngeal volume, and total airway volume was seen post expansion. Oropharyngeal volume and minimum cross-sectional area, showed a volumetric increase. Clinical evaluation showed a significant improvement in the airway collapse at the level of oropharynx. This corresponded with the findings of the radiographic evaluation.
Conclusion:
The study results showed a significant improvement in nasopharyngeal and total airway volume following MARPE with significant improvement in pharyngeal airway in the region of oropharynx. MARPE can be recommended as a promising therapy for airway constriction in adolescents and young adults.
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