Abstract | OBJECTIVES: The objectives of this study were to confirm the efficacy of rapid maxillary expansion in children with moderate adenotonsillar hypertrophy in a larger sample and to evaluate retrospectively its long-term benefits in a group of children who underwent orthodontic treatment 10 years ago. METHODS: After general clinical examination and overnight polysomnography, all eligible children underwent cephalometric evaluation and started 12 months of therapy with rapid maxillary expansion. A new polysomnography was performed at the end of treatment (T1). Fourteen children underwent clinical evaluation and Brouilette questionnaire, 10 years after the end of treatment (T2). RESULTS: Forty patients were eligible for recruitment. At T1, 34/40 (85%) patients showed a decrease of apnea-hypopnea index (AHI) greater than 20% (ΔAHI 67.45% ± 25.73%) and were defined responders. Only 6/40 (15%) showed a decrease <20% of AHI at T1 and were defined as non-responders (ΔAHI -53.47% ± 61.57%). Moreover, 57.5% of patients presented residual OSA (AHI > 1 ev/h) after treatment. Disease duration was significantly lower (2.5 ± 1.4 years vs 4.8 ± 1.9 years, p <0.005) and age at disease onset was higher in responder patients compared to non-responders (3.8 ± 1.5 years vs 2.3 ± 1.9 years, p <0.05). Cephalometric variables showed an increase of cranial base angle in non-responder patients (p <0.05). Fourteen children (mean age 17.0 ± 1.9 years) who ended orthodontic treatment 10 years previously showed improvement of Brouilette score. CONCLUSION: Starting an orthodontic treatment as early as symptoms appear is important in order to increase the efficacy of treatment. An integrated therapy is needed.
|
Authors | Maria Pia Villa, Alessandra Rizzoli, Jole Rabasco, Ottavio Vitelli, Nicoletta Pietropaoli, Manuela Cecili, Alessandra Marino, Caterina Malagola |
Journal | Sleep medicine
(Sleep Med)
Vol. 16
Issue 6
Pg. 709-16
(Jun 2015)
ISSN: 1878-5506 [Electronic] Netherlands |
PMID | 25934539
(Publication Type: Clinical Study, Journal Article)
|
Copyright | Copyright © 2014 Elsevier B.V. All rights reserved. |
Topics |
- Cephalometry
- Child
- Child, Preschool
- Cooperative Behavior
- Early Medical Intervention
- Female
- Humans
- Interdisciplinary Communication
- Male
- Palatal Expansion Technique
- Polysomnography
- Prospective Studies
- Retrospective Studies
- Sleep Apnea, Obstructive
(diagnosis, etiology, therapy)
- Treatment Outcome
|