Evaluation of changes in cephalometric and clinical airway indices in patients after rapid palatal expansion

Aim: The main objective of our study is to evaluate the clinical appropriateness od cephalometric and clinical parameters in patients with potential sleep disorders treatment with rapid maxillary expander (RME). RME is an orthopaedic treatment which is affective in correcting the maxillary constriction and also reducing the resistance of the upper airways thus being widely use in the treatment of obstructive sleep apnoea (OSA)in children. OSA are included in the broader context of the respiratory sleep disorders (RSD) and affect approximately 2-4%of children, leading to systemic, neurocognitive and behavioural problems. Materials and methods: patients of the orthodontics clinic of Rho hospital, age between 6 and 11 years old, needing an orthodontic therapy with RME are evaluated. Patient are assessed at three time points (T0, before treatment, at T1, after the active phase of expansion and at T2, at the end of treatment) evaluating cephalometric parameters on lateral cephalometric teleradiographs such as PAS (the posterior airways space), MP-H, SNP-P. Moreover, we take into consideration the hyoid – chin distance and we administer an abbreviated sleep questionnaire to the parents, in order to inquire the child’s sleep habits. Results and conclusions: 36 patients met the inclusion criteria and were enrolled in our study. Data regarding the first 19 patients were analysed as the study is currently in progression in order to determine whether there are significant data. Mallampati score and tonsillar grading are useful in evaluating the improvement of orthodontic patients but are influenced by many external parameters such as the dimension of the tongue and are operator dependent while cephalometric parameters and the hyoid chin distance are appropriate and more objective. The combination od clinical data such as the Mallampati scale and tonsillar grading with these parameters may help in the accuracy of post expansion airway assessment and first data encourage us to carry on with research.