Changes in hyoid bone position following rapid maxillary expansionin adolescents
; Manish Valiathan
; Suchitra Nelson
; Kingman P. Strohl
; Mark Hans
To examine changes in hyoid to mandibular plane distance (H-MP) and tongue length(TL) between children who had orthodontic treatment with and without rapid maxillary expansion(RME).
Materials and Methods:
Lateral and frontal cephalograms of 138 patients treated with RME and148 controls treated without RME were used to measure pretreatment (T
) and posttreatment (T
)intermolar (IM) distance, lateronasal width (LNW), H-MP, and TL. Medical histories were used tocollect demographic information, history of mouth breathing, difficulty breathing through the nose,and previous adenotonsillectomy. Groups were group-matched for age and gender. Descriptivestatistics were calculated. Group means were compared using
-tests and chi-square statistics.Reliability was estimated using intraclass correlations and kappa statistics. Statistical significancewas set at
, the RME group showed smaller LNW (24.83
1.99 vs 26.18
2.05) and IM(50.17
2.3 vs 51.58
2.83). The distance from H-MP was longer in the RME group (15.69
3.95 vs 13.86
3.4). Mean changes (T
) in the RME group were increased LNW (
1.11 for the non-RME group) and IM (
1.67). The meanchange (T
) in H-MP for the RME group was
3.67 compared with
2.96 for thenon-RME group. Mean changes for TL were not statistically significant. No significant differenceswere noted at T
between groups for LNW, H-MP, or TL.
In this sample, RME produced significant changes in H-MP, and TL was unaffected.(
Rapid maxillary expansion; Airway; Hyoid bone
Orthodontic treatment provides many benefits topatients. Improved esthetics and masticatory functionare the best known. Recent evidence suggests thatdevices designed to protrude the mandible may beeffective for the treatment of breathing problems andsnoring.
The goal of such therapy is to modify theposition of upper airway structures in efforts to enlargethe airway and reduce its collapsibility.Another way to reduce upper airway collapsibility isto reduce the resistance to airflow within the airwaypassage. Maxillary transverse deficiency reduces thecross-sectional area of the airway, leading to in-creased nasal resistance. Previous studies havedemonstrated a reduction in nasal resistance followingrapid maxillary expansion (RME) with banded orbonded appliances.
Evidence suggests that RMEmay reduce the apnea hypopnea index in children withsleep apnea.
Improved nasal airflow and resolutionof obstructive sleep-disordered breathing have beenreported in adults undergoing surgically assistedRME.
RME treatment improves nasal breathing bysignificantly increasing total minimum cross-sectionalarea and total nasal volume.
Private practice, Portland, Ore.
Assistant Professor, Department of Orthodontics, CaseWestern Reserve University, Cleveland, Ohio.
Associate Professor, Department of Community Dentistry,Case Western Reserve University, Cleveland, Ohio.
Professor of Medicine, Anatomy, and Orthodontics; Director,Center for Sleep Disorders Research, Louis Stokes DVA MedicalCenter, Case Western Reserve University, Cleveland, Ohio.
Professor and Chairman, Department of Orthodontics, CaseWestern Reserve University, Cleveland, Ohio.Corresponding author: Dr Manish Valiathan, Assistant Pro-fessor, Department of Orthodontics, School of Dental Medicine,Case Western Reserve University, 10900 Euclid Ave, Cleveland,OH 44106(e-mail: firstname.lastname@example.org).Accepted: October 2010. Submitted: June 2010.Published Online: February 9, 2011
2011 by The EH Angle Education and Research Foundation,Inc.
Angle Orthodontist, Vol 81, No 4, 2011