Abstract Background The effects of rapid palatal expansion (RPE) on sleep-related breathing and nasal airway resistance have been extensively investigated in prepubertal individuals; however, interpretation of these findings is confounded by growth-related changes. Objective To evaluate and compare the effects of different RPE appliance designs (tooth-tissue supported and tooth-bone supported) on sleep-related breathing, nasal airway resistance, and dentoskeletal/dentoalveolar outcomes in postpubertal adolescents with maxillary constriction, incorporating an age-matched control group to account for nontreatment related changes. Trial design Prospective randomized controlled trial conducted over a 1-year study period, including recruitment, intervention, and short-term follow-up. Methods Participants The study included 45 individuals aged between 14 and 17 who were in the postpubertal growth stage and exhibited maxillary constriction 0.15 individuals of the same age group without maxillary constriction were included in the control group. Interventions These patients were randomly divided into three groups; each applied different RPE appliance types. Outcomes Nasal resistance with anterior rhinomanometry, sleep-related breathing assessed using respiratory polygraphy and questionnaires, dentoskeletal and dentoalveolar effects with Posteroanterior (PA) radiographs and study models were investigated. Records were taken before expansion and after 3 months. Randomization Individuals other than the control group were assigned to the groups using a computer-assisted randomization program (http://random-allocation-software.software.informer.com/2.0/). Limitations This study includes partial blinding, a modest sample size, a short follow-up period, and the use of respiratory polygraphy instead of polysomnography. Results With the RPE treatment, a decrease in AHI (Apnea-Hypopnea Index), De SPO2 (Number of oxygen desaturations), and TNR (Total Nasal Resistance) values was observed in all three groups. There was a significant increase in maxillary and nasal width in the FCRPE (Full Coverage RPE) and MARPE (Mini-implant Assisted RPE) groups, while only the maxillary width increase was significant in the MMRPE (Modified McNamara RPE) group. Conclusion RPE treatment decreases AHI and TNR, approaching the values of individuals in the control group. In the MARPE group, a greater decrease in AHI was observed compared with the MMRPE group. Features suggestive of Obstructive Sleep Apnea Syndrome (OSAS) were commonly observed in postpubertal adolescents with maxillary constriction. Trial registration number NCT06009796.
Soylu et al. (Fri,) studied this question.