Abstract
Background
The purpose of this clinical study was to assess the effects of different rapid maxillary expansion appliances on the severity of obstructive sleep apnea (OSA).
Material and methods
Patients having a narrow maxilla and identified with OSA were divided randomly into three groups: tooth tissue-borne, tooth-borne, and bone-borne expanders. Changes in sleep parameters at baseline and 3-month follow-up detected by polygraphy were the primary outcome. Treatment of the crossbite was the secondary outcome. Dunn-Bonferroni tests, Kruskal–Wallis, and Wilcoxon analysis were applied for intra- and inter-group differences at p < 0.05 significance level.
Results
Among 46 patients randomized, apnea-hypopnea index (AHI) changed from baseline to follow-up in all groups (− 1.6, p = 0.280; 0.6, p = 0.691; − 0.45, p = 0.796, respectively), with no between-group difference (p = 0.631). Oxygen desaturation index (ODI) altered from baseline to follow-up in all groups (0.80, p = 0.977; 0.20, p = 0.932; and − 1.00, p = 0.379, respectively), with no between-group difference (p = 0.858). There was no significant difference in minimum oxygen saturation from baseline to follow-up in all groups (0.00, p = 0.401; − 2.00, p = 0.887; 0.50, p = 0.407, respectively). No significant changes were observed in supine AHI from baseline to follow-up in all groups (0.00, p = 0.581; − 1.00, p = 0.393; 0.00, p = 0.972, respectively). The upper intermolar width increased from baseline to follow-up in all groups (5.04, p = 0.000; 3.15, p = 0.001; 5.41, p = 0.00, respectively) with no between-group difference (p = 0.560). Maxillary width increased from baseline to follow-up in all groups (4.25, p = 0.001; 4.74, p = 0.00; 4.49, p = 0.001, respectively) with no inter-group difference (p = 0.963).
Conclusions
The amount of skeletal and dental expansion obtained in the maxilla was similar in all groups. Rapid maxillary expansion was not found to be effective in OSA treatment.
Trial registration
ClinicalTrials.gov Identifier: NCT04604392.
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Data availability
The data used to support the findings of this study are available from the corresponding author and first author upon request.
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Acknowledgements
We thank to associate professor Dr. Ferhan Elmalı for his assistance with the statistical analysis.
Funding
This trial was supported by Izmir Katip Celebi University, Scientific Research Projects Unit (grant number 2016-TDR-SABE-0024).
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This study was confirmed by the Ethics Committee of Clinical Trials, EGE University no: 16–5.2/12.
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Gokce, G., Basoglu, O.K. & Veli, I. Polygraphic evaluation of the effects of different rapid maxillary expansion appliances on sleep quality: A randomized clinical trial. Sleep Breath 27, 651–659 (2023). https://doi.org/10.1007/s11325-022-02677-0
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DOI: https://doi.org/10.1007/s11325-022-02677-0