Rapid maxillary expansion and nasal patency in mouth breathing children with maxillary atresia due to or not due to allergic rhinitis.

AIM: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency in mouth breathing (MB) children with maxillary atresia due to or not due to allergic rhinitis (AR) associated with asthma. METHODS: Fifty-three MB children/adolescents (aged 7-14 years) with mixed or permanent dentition and maxillary atresia participated, with or without unilateral or bilateral crossbite. They formed the groups: RAD (AR + asthma; clinical treatment, RME); RAC (AR + asthma; clinical treatment, no RME); and D (mouth breathers; RME only). RAD and RAC patients received topical nasal corticosteroid and/or systemic H1 antihistamine (continuous use) and environmental exposure control. All were evaluated before RME (T1) and 6 months after (T2) with the CARATkids score, acoustic rhinometry, and nasal cavity computed tomography (CT). Patients RAD and D underwent RME (Hyrax® orthopedic appliance). RESULTS: A significant reduction in the CARATkids score occurred in the RAD (-4.06; p < 0.05), similarly when patient and parent/guardian scores were evaluated (-3.28 and -3.16, respectively). Acoustic rhinometry (V5) showed increased nasal volume in all groups, significantly higher in RAD patients than in RAC and D (0.99 × 0.71 × 0.69 cm3, respectively). CT of the nasal cavity documented increased volume in all three groups, with no significant differences between them. CONCLUSION: In MB patients with AR, asthma, and maxillary atresia, RME increased nasal cavity volume and improved respiratory symptoms. However, it should not be used as the only treatment for managing patients with respiratory allergies.

Avaliação tomográfica do impacto da expansão rápida da maxila nas dimensões faciais / Tomography evaluation of the impact of the rapid maxillary expansion on facial dimensions

O objetivo foi avaliar, através da tomografia computadorizada cone beam (TCCB), as mudanças lineares ocorridas na altura e largura faciais pós-expansão rápida da maxila (ERM) em crianças respiradoras bucais. Foram selecionados 30 pacientes para o procedimento de ERM, portadores de constrição maxilar, sendo 13 meninas (43,3%) com média de idade de 10,2 anos, variando entre 8 a 12 anos e desvio padrão de 1,7 anos, e 17 meninos (56,7%) com média de idade de 9,8 anos, variando entre 7 e 12 anos e desvio padrão de 1,8 anos. Inicialmente ao procedimento ERM e 03 meses pós-finalização, os pacientes foram submetidos ao exame de TCCB para obtenção das medidas de altura e largura faciais por meio do programa de imagens Implantviewer®. Ocorreu um aumento significativo nas medidas de altura e largura faciais, sendo que a média da altura facial pré e pós-procedimento foram 119,92 mm e 122,54 mm, respectivamente. Em relação à largura facial, a média foi de 112,15 mm pré-ERM e 114,25 mm pós-ERM.(AU)

The objective was to evaluate by cone-beam computed tomography (CBCT), the linear changes occurred at height and facial width after rapid maxillary expansion (RME) in mouth breathing children. The sample consisted of 30 patients (13 female and 17 male) for the RME procedure, a mean age of 10.2 years, ranging from 8 to 12 years and standard deviation of 1.7 years for female (43.3%), and mean of 9.8 years, ranging from 7 to 12 years and standard deviation of 1.8 years for male (56.7%). CBCT images were taken at T1 (before RME) and T2 (3 months after the completion of maxillary expansion activation) as part of clinical records. Facial height and width measurements were evaluated using Implantviewer® software. Significant increase in the measures of facial height and width, and the mean amount of the pre and post facial height were 119.92 mm and 122.54 mm, respectively. Regarding facial width, the mean was of 112.15 mm (pre ERM) and 114.25 mm (post ERM). (AU)