Maxillary expansion procedures were associated with increased airway volume and reduced apnea–hypopnea index in pediatric and adult patients with obstructive sleep apnea, according to a review of clinical studies. Reported outcomes included improved airflow, higher oxygen saturation, reduced sleepiness scores, and better quality-of-life measures. Outcomes varied by patient age, sex, and expansion technique.
In adult patients who underwent mini-screw–assisted rapid palatal expansion (MARPE), one prospective trial reported that mean apnea–hypopnea index (AHI) decreased from 29 to 12 events per hour, a 65% reduction. Mean oxygen saturation rose from 92% to 94%, Epworth Sleepiness Scale scores declined from 13 to 7, and quality-of-life scores improved. Reported airway volume increased by 9% to 23% in the nasal cavity following expansion and up to 77% following retention.
Age and sex influenced results. Success rates for suture separation were 100% in adolescents and 86% in adults aged 25 to 34 years, but lower in male compared with female patients. In one data set, no successful separation was achieved in men older than 30 years.
Surgically assisted rapid palatal expansion (SARPE) produced stable skeletal widening and nasal airway enlargement in skeletally mature patients. Distraction osteogenesis maxillary expansion (DOME) also reduced obstructive sleep apnea (OSA) severity in adults. In one cohort of 75 patients, mean AHI decreased from 18 to 8, rapid eye movement sleep increased from 14% to 23%, and nasal obstruction and sleepiness scores improved.
Complications varied by technique. MARPE was associated with mucosal inflammation in most patients, tenderness, device breakage, and asymmetric expansion. DOME complications were generally minor and included transient paresthesia and rare tooth vitality loss.
The review included studies published in the past 10 years, identified through PubMed, Cochrane, and Google Scholar. Evidence was drawn from randomized trials, prospective and retrospective series, and systematic reviews. “Unlike meta-analyses that may impose strict inclusion thresholds or focus on a narrow patient population, this review integrates findings across broader clinical contexts to assist in real-world decision-making,” said lead author Mohammad Qali, DDS, PhD, of the Department of Surgical Sciences, College of Dentistry, Health Sciences Center, Kuwait University, Kuwait City.
Limitations included small sample sizes, short follow-up periods, and heterogeneous study designs. No formal risk-of-bias assessment was conducted. Long-term durability of airway and sleep improvements remained unclear, and complications were inconsistently reported.
Maxillary expansion techniques increased nasal and nasopharyngeal airway volume and reduced OSA severity in selected patients. Reported benefits differed by age, sex, and skeletal maturity. Researchers stated that larger controlled studies are needed to confirm long-term outcomes and to better define patient selection.
The authors reported no conflicts of interest.
Source: Dentistry Journal
