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Qi Y, Ding L, Xue L, Xu S, Lin J. Analysis of changes and correlation in condyle-fossa relationship after maxillary skeletal expansion. Orthod Craniofac Res 2024. [PMID: 38566529 DOI: 10.1111/ocr.12786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To investigate the changes in condyle-glenoid fossa relationship after maxillary skeletal expansion (MSE) and to verify the correlation between the condyle positional changes and expansion effect. METHODS In this study, 20 patients (mean age 21.1 ± 5.7 years, 8 male, 12 female) with maxillary transverse deficiency (MTD) were treated with the MSE appliance, which contained molar bands and a expander with four micro-implants. The CBCT images were taken before expansion (T0), after expansion (T1) and after 6 months of maintenance (T2). The posterior TMJ space (PS), superior TMJ space (SS), anterior TMJ space, coronal lateral TMJ space (CLS), coronal medial TMJ space (CMS), condyle axis angle, maxillary basal bone width (BWM), inter-molars width, nasal bone width, molar inclination and molar palatal cusp height (U6H) were measured using Dolphin Imaging. RESULTS At T1, compared with T0, the PS and SS significantly increased by 0.41 mm (P = .008) and 0.3 mm (P = .007). But only the SS significantly increased by 0.21 mm (P = .025) at T2. There was a significant difference of 0.37 mm (left-right, P = .014) between the left and right SS at T0, but no significant difference at T1 and T2. The increased BMW showed weak positive correlations with the change of PS (P = .015) and CMS (P = .031), and the decreased U6H showed weak negative correlations with the change of PS (P = .015) and CLS (P = .031) at T1. CONCLUSIONS The use of MSE led to an increase in the SS and PS, which were weakly correlated with BWM and U6H. But this effect in the TMJ space gradually diminished after 6 months of maintenance, and the symmetry of the condyle-fossa relationship was preserved.
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Affiliation(s)
- Yezi Qi
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, P.R. China
| | | | - LeiLei Xue
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, P.R. China
| | - SiYi Xu
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, P.R. China
| | - Jun Lin
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, P.R. China
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Lin JH, Li C, Wong H, Chamberland S, Le AD, Chung CH. Asymmetric Maxillary Expansion Introduced by Surgically Assisted Rapid Palatal Expansion: A Systematic Review. J Oral Maxillofac Surg 2022; 80:1902-1911. [PMID: 36113583 DOI: 10.1016/j.joms.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE A commonly reported complication of surgically assisted rapid palatal expansion (SARPE) that has not been explored extensively is uneven expansion between left and right sides, which requires secondary surgery for correction. This systematic review aims to analyze the prevalence and potential causes of asymmetric expansion in the transverse dimension after SARPE to guide the clinical practice. METHODS Electronic databases and manual search were used to search for original articles published on SARPE on March 11, 2022. Original human studies that recorded the number and percentage of asymmetric expansion after two-piece SARPE were included. The 2020 Preferred Reporting Items for Systemic Reviews and Meta-Analyses guideline was implemented for the quality assessment and data analysis of the included articles. The study was registered at the International Prospective Register of Systematic Reviews under the number CRD42022300782. RESULTS After applying inclusion and exclusion criteria, 13 articles were included in the final review. The risk of bias was high in 8 studies and medium in the other 5 studies. Overall, the prevalence of asymmetric expansion in the transverse dimension (different amount of expansion between left and right sides) was 7.52%, with 12.90% of patients involved receiving a second surgery for correction. Expander design did not significantly affect the rate of asymmetry expansion. Pterygomaxillary fissure release significantly increased the rate of asymmetry expansion (11.02% vs 5.08%, P < .001). In comparison, lateral nasal wall osteotomy (4.26% vs 14.77%, P < .001) and release of the nasal septum (5.22% vs 17.15%, P < .001) significantly lowered the rate of asymmetry expansion, respectively. CONCLUSIONS Asymmetric dentoskeletal expansion between left and right sides is a common complication of SARPE procedures, mostly caused by variations in surgical cuts. However, the risk of bias in currently available publications is high. Further studies are warranted to fully understand the causes of asymmetric expansion.
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Affiliation(s)
- Jia-Hong Lin
- Orthodontic Resident, Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Chenshuang Li
- Assistant Professor, Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Hilary Wong
- Dental Student, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Anh D Le
- Chair And Norman Vine Endowed Professor Of Oral Rehabilitation, Department of Oral and Maxillofacial Surgery/Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Chun-Hsi Chung
- Associate Professor and Chauncey M. F. Egel Endowed Chair and Director, Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
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Salmoria I, de Souza EC, Furtado A, Franzini CM, Custodio W. Dentoskeletal changes and their correlations after micro-implant-assisted palatal expansion (MARPE) in adults with advanced midpalatal suture ossification. Clin Oral Investig 2021; 26:3021-3031. [PMID: 34773143 DOI: 10.1007/s00784-021-04284-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate and correlate the dentoskeletal changes of adult patients after miniscrew-assisted rapid palatal expander (MARPE) in the two final stages of midpalatal suture ossification. MATERIALS AND METHODS This interventional pre-post clinical study consisted of 20 adults (24.9±1.8 years), with transverse maxillary atresia, divided into two subgroups (n=10) based on the ossification degree of the midpalatal suture: stage D, fusion completed in the palatine bone; and stage E, fusion anteriorly in the maxilla. Cone beam computed tomography (CBCT) in the pre- (T0) and post-treatment (T1) time intervals were used to evaluate the anterior and posterior sutural opening, activation of the expander screw, vestibular-lingual inclinations, and widths of first premolars and first molars. Maxillary interincisor diastema was measured on patients' plaster models in the same timepoints. The Wilcoxon-Mann-Whitney test, generalized linear models (GLM), and chi-square (χ2) test were employed. RESULTS All variables significantly increased after MARPE therapy regardless of the ossification degree (P<0.05). Patients with stage D suture presented wider interincisal diastema and maxillary suture opening (on both regions, anterior and posterior) when compared with patients with stage E (P<0.05). Maxillary interincisor diastema was positively associated with anterior and posterior suture opening for all subjects (P<0.05). MARPE therapy was unsuccessful in six patients, mostly presented by individuals with E maturation stage of the midpalatal suture. CONCLUSIONS After MARPE, a significant correction in the transverse defect of the maxillary basal bone was achieved for adults in the last two midpalatal suture maturation stages. CLINICAL RELEVANCE Adult patients in stage D of maxillary suture ossification are more susceptible to dentoskeletal changes following MARPE therapy as compared to patients with stage E.
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Affiliation(s)
- Igor Salmoria
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil
| | - Evaldo Chaves de Souza
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil
| | - Alvaro Furtado
- Department of Orthodontics, Centro Universitário Unifacvest: Centro Universitario Unifacvest, Florianópolis, SC, Brazil
| | - Cristina Maria Franzini
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil
| | - William Custodio
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil.
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Li J, Shi L, Zhang X, Weng L, Chen H, Lin J. Evaluating the effect of midpalatal corticotomy-assisted rapid maxillary expansion on the upper airway in young adults using computational fluid dynamics. J Zhejiang Univ Sci B 2021; 22:146-155. [PMID: 33615755 DOI: 10.1631/jzus.b2000090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Midpalatal corticotomy-assisted rapid maxillary expansion (MCRME) is a minimally invasive treatment of maxillary transverse deficiency (MTD) in young adults. However, the effect of MCRME on respiratory function still needs to be determined. In this study, we evaluated the changes in maxillary morphology and the upper airway following MCRME using computational fluid dynamics (CFD). Twenty patients with MTD (8 males, 12 females; mean age 20.55 years) had cone-beam computed tomography (CBCT) images taken before and after MCRME. The CBCT data were used to construct a three-dimensional (3D) upper airway model. The upper airway flow characteristics were simulated using CFD, and measurements were made based on the CBCT images and CFD. The results showed that the widths of the palatal bone and nasal cavity, and the intermolar width were increased significantly after MCRME. The volume of the nasal cavity and nasopharynx increased significantly, while there were no obvious changes in the volumes of the oropharynx and hypopharynx. CFD simulation of the upper airway showed that the pressure drop and maximum velocity of the upper airway decreased significantly after treatment. Our results suggest that in these young adults with MTD, increasing the maxillary width, upper airway volume, and quantity of airflow by MCRME substantially improved upper airway ventilation.
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Affiliation(s)
- Juan Li
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Lingfang Shi
- Department of Stomatology, the First People's Hospital of Xiaoshan, Hangzhou 311200, China
| | - Xiayao Zhang
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Luxi Weng
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Hong Chen
- Department of Stomatology, Zhejiang Provincial People's Hospital (People's Hospital of Hangzhou Medical College), Hangzhou 310014, China
| | - Jun Lin
- Department of Stomatology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
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Yu TT, Li J, Liu DW. Seven-year follow-up of the nonsurgical expansion of maxillary and mandibular arches in a young adult: A case report. World J Clin Cases 2020; 8:5371-5379. [PMID: 33269272 PMCID: PMC7674729 DOI: 10.12998/wjcc.v8.i21.5371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/28/2020] [Accepted: 08/31/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Palatal expansion treatment has been used to expand the constricted maxillary arch and has become a routine procedure in orthodontic practice over the past decades. However, the long-term stability of expansion in the permanent dentition without a surgical approach is uncertain.
CASE SUMMARY We present the case of a 15-year-old boy with Class II malocclusion and constricted arches. The patient was treated with rapid palatal expansion (RPE) followed by a fixed orthodontic appliance. A 7-year follow-up evaluation was performed by analyzing cephalometric radiographs, plaster models, and photographs. The patient’s constricted maxillary and mandibular arches were relived after the expansion treatment. A Class I occlusion and normal arch form were established and maintained in the long-term.
CONCLUSION RPE treatment is successful in solving constricted dental arch in the permanent dentition without a surgical approach. Permanent retention and even occlusal contact help prevent long-term relapse.
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Affiliation(s)
- Ting-Ting Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jing Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Da-Wei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Maya R, Ladeira LLC, Maya JEP, Mail LMG, Bussadori SK, Paschoal MAB. The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report. J Lasers Med Sci 2020; 11:228-233. [PMID: 32273968 DOI: 10.34172/jlms.2020.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: One of the unexpected side effects of the Haas type palatal expander is ulcers progressing to necrotic lesions in the palatal area due to poor hygiene. The use of antibiotic therapy is mandatory. However, long periods of healing/pain and the need for a systemic host response with the aid of metabolization, especially in children, are issues that should be taken into account in the management of this type of injury. Since phototherapy modalities (antimicrobial photodynamic therapy [aPDT] and photobiomodulation therapy [PBMT]) are able to enhance and accelerate the healing process and reduce the bacterial load, this case report aimed to describe the use of the above-mentioned therapies to treat palatal ulcers occurring during orthodontic expansion. Case Report: The patient, a 10-year-old boy, with a chief complaint of bleeding and continuous pain in the region of his expander was verified on a follow-up visit. After a dental examination, the expander was removed and two necrotic lesions which were in contact with the acrylic part of the tooth-tissue expander were found in the palatal region. The proposal was to use one aPDT session with methylene blue followed by 4 sessions of PBMT with a red laser diode. On the 5th day, reorganized tissue was verified, with the absence of bleeding, swelling, and pain. On the 20th day of follow-up, the area showed no signs of inflammation, healthy tissue without any pathological clinical symptoms, and complete wound healing. Conclusion: The concomitant use of PBMT and aPDT therapies may be considered feasible as an adjunct treatment to manage palatal ulcers resulting from the incorrect use of tooth-tissue types of expanders.
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Affiliation(s)
- Rafael Maya
- Florence Institute of Superior Teaching, São Luís - MA, Brazil
| | | | | | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho - UNINOVE, São Paulo - SP, Brazil
| | - Marco Aurélio Benini Paschoal
- Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais - UFMG, Belo Horizonte - MG, Brazil
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da Fonseca EV, Bussadori SK, da Silva Martinho LFC, de Souza Melo MC, de Andrade FL, Gonçalves MLL, Mesquita-Ferrari RA, Horliana ACRT, Fernandes KPS. Evaluation of photobiomodulation effects on pain, edema, paresthesia, and bone regeneration after surgically assisted rapid maxillary expansion: Study protocol for a randomized, controlled, and double blind clinical trial. Medicine (Baltimore) 2019; 98:e17756. [PMID: 31770194 PMCID: PMC6890349 DOI: 10.1097/md.0000000000017756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Surgically assisted rapid maxillary expansion (SARME) generates an uncomfortable postoperative period accompanied by pain, edema, and paresthesia. There are few studies on the effect of photobiomodulation (PBM) after SARME and it was not possible to find studies on the efficacy of light emitted by diode (LED) after this type of intervention. The main objective of the study will be to evaluate the efficacy of PBM with LED in the control of pain, facial edema, paresthesia, and bone repair after SARME. METHODS A randomized, double-blind, placebo-controlled clinical trial involving 72 participants aged from 18 to 45 years, who search the Department of Buccomaxillofacial Surgery and Traumatology of Mandaqui Hospital Complex, will be conducted. Immediately after surgeries, the participant will be inserted into the placebo or LED group. In the LED group, the participants will receive PBM with an extraoral device (660 and 850 nm with 6 J per point) and an intraoral device (660 nm with 2 J per point) and in the control group the person in charge of the application will simulate the irradiation with the devices kept off. The applications will be in the immediate postoperative period, 1, 2, 7, 14, 30, 60, 90, and 120 days after the end of the surgeries, when the evaluations will also be performed. Facial measurements, extra and intraoral sensitivity, pain and bone repair will be evaluated. Secondarily, data regarding the occurrence of headache; otalgia; nausea; bruising; nasolacrimation; epistaxis; dysphagia; systemic and superficial temperature in the operated region; use of analgesics and anti-inflammatories; anxiety and impact of oral health on the participants' quality of life will be computed. DISCUSSION Since PBM has shown positive effects on postoperative complications of other types of oral surgery and also has a positive effect on bone repair after maxillary disjunction, surgically assisted or not, it seems clear the need to evaluate its performance regarding pain, edema, and paresthesia after these surgeries. TRIAL REGISTRATION This protocol was registered in Clinical Trials platform (https://clinicaltrials.gov/) with the number NCT03814525, first published and last updated on January 24, 2019.
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Affiliation(s)
- Eduardo Vasques da Fonseca
- Postgraduation Program in Biophotonics Applied to Health Sciences, Nove de Julho University - UNINOVE, Liberdade
- Department of Buccomaxillofacial Surgery and Traumatology of Mandaqui Hospital Complex, Santana, São Paulo, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduation Program in Biophotonics Applied to Health Sciences, Nove de Julho University - UNINOVE, Liberdade
| | | | - Maria Carolina de Souza Melo
- Department of Buccomaxillofacial Surgery and Traumatology of Mandaqui Hospital Complex, Santana, São Paulo, SP, Brazil
| | - Felipe Ledo de Andrade
- Department of Buccomaxillofacial Surgery and Traumatology of Mandaqui Hospital Complex, Santana, São Paulo, SP, Brazil
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Surgically assisted rapid maxillary expansion: a systematic review of complications. Int J Oral Maxillofac Surg 2019; 49:325-332. [PMID: 31500954 DOI: 10.1016/j.ijom.2019.08.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/14/2019] [Accepted: 08/20/2019] [Indexed: 11/22/2022]
Abstract
A systematic review of the literature on the complications of surgically assisted maxillary expansion (SARME) was performed. The search strategy was based on the PRISMA guidelines. The PubMed, SCOPUS, and Cochrane Library databases were searched. Data were extracted from the full texts after screening of the abstracts and titles. Human clinical studies encompassing 'maxillary expansion', 'palatal expansion', 'SARME', or 'SARPE' and that reported sufficient data for 'complication' were included. In vitro studies, case reports, meta-analyses, reviews, book chapters, animal studies, and studies with missing or insufficient data were excluded. The final selection included 12 articles for data extraction. A total of 851 patients underwent SARME, with 187 reported complications (21.97%). Epistaxis (2.47%) and postoperative pain (2.00%) were the most often reported minor complications, and asymmetric or inadequate expansion presented an occurrence rate of 4.47%. Minor complications were equally distributed between surgical (49.30%) and orthodontic complications (50.70%). The technique without pterygomaxillary disjunction increased the occurrence of minor complications (29.95% vs. 16.87%), and the expansion pattern with less than 0.5 mm/day increased the occurrence of orthodontic complications (30.93% vs. 1.83%), i.e. asymmetric expansion. In conclusion, SARME procedures mostly present minor complications. Although several types of complication are described in the literature, occurrence rates are low, and technical issues such as pterygomaxillary disjunction and the pattern of distraction can be predictors of the complication risk.
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Bloomquist DS, Joondeph DR. Orthognathic surgical procedures on non-growing patients with maxillary transverse deficiency. Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Li K, Quo S, Guilleminault C. Endoscopically-assisted surgical expansion (EASE) for the treatment of obstructive sleep apnea. Sleep Med 2018; 60:53-59. [PMID: 30393018 DOI: 10.1016/j.sleep.2018.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/08/2018] [Accepted: 09/12/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this retrospective study was to evaluate the results of an outpatient surgical procedure known as endoscopically-assisted surgical expansion (EASE) in expanding the maxilla to treat obstructive sleep apnea (OSA) in adolescent and adults. METHODS Thirty-three patients (18 males), aged 15-61 years, underwent EASE of the maxilla. All patients completed pre- and post-operative clinical evaluations, polysomnography, questionnaires (Epworth Sleepiness Scale [ESS] and Nasal Obstruction Septoplasty Questionnaire [NOSE]) as well as cone beam computed tomography (CBCT). RESULTS With EASE, the overall apnea hypopnea index (AHI) improved from 31.6 ± 11.3 to 10.1 ± 6.3. The oxygen desaturation index (ODI) improved from 11.8 ± 9.6 to 1.8 ± 3.7, with reduction of ESS scores from 13.4 ± 4.0 to 6.7 ± 3.1. Nasal breathing improved as demonstrated by reduction of the NOSE scores from 57.8 ± 12.9 to 15.6 ± 5.7. Expansion of the airway from widening of the nasal floor was consistently evident on all postoperative CBCT; the anterior nasal floor expanded 4.9 ± 1.2 mm, posterior nasal floor expanded 5.6 ± 1.2 mm, and the dental diastema created was 2.3 ± 0.8 mm. Mean operative time was 54.0 ± 6.0 min. All patients with mild to moderate OSA were discharged the same day; patients with severe OSA were observed overnight. All patients returned to school or work and regular activities within three days. CONCLUSIONS EASE is an outpatient procedure that improves nasal breathing and OSA by widening the nasal floor in adolescents and adults. Compared to current surgical approaches for maxillary expansion, EASE is considerably less invasive and consistently achieves enlargement of the airway with minimal complications.
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Affiliation(s)
- Kasey Li
- Sleep Apnea Surgery Center, East Palo Alto, CA, USA.
| | - Stacey Quo
- School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
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