Hoxha Saimir, Kaya-Sezginer Ecem, Bakar-Ates Filiz, Köktürk Oğuz, Toygar-Memikoğlu Ufuk
Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey.
Department of Biochemistry, Faculty of Pharmacy, Ankara University, Tandogan, 06100, Ankara, Turkey.
Sleep Breath. 2018 Dec;22(4):1053-1061. doi: 10.1007/s11325-018-1636-4. Epub 2018 Feb 17.
The purpose of this study was to investigate the effect of semi-rapid maxillary expansion (SRME) orthodontic treatment on biomarkers and respiratory parameters in children with obstructive sleep apnea syndrome (OSAS) and maxillary transverse deficiency.
Thirty children with OSAS were included in this study. Fifteen children were enrolled as control, and 15 children were subjected to SRME orthodontic treatment method for 5 months. Beside respiratory parameters, pharyngeal area, dental arch, and postero-anterior widths and the levels of OSAS biomarkers in serum and urine were measured.
Pharyngeal airway space, dental arch, and postero-anterior widths were increased after SRME treatment. Sleep tests showed a decrease in the apnea-hypopnea index (AHI) after 5-month control/treatment duration. Serum kallikrein (KLK)1 levels decreased significantly in the treatment group. There was a significant increase in serum orosomucoid (ORM)2 levels and a decrease in urine perlecan levels in the control group after a 5-month follow-up. A significant negative correlation between serum ORM2, perlecan, gelsolin, and KLK1 levels and intercanin width, as well as between serum ORM2 and KLK1 levels and intermolar width, was observed.
SRME treatment can be considered as a useful approach in children with OSAS. A further investigation of OSAS-related biomarkers and their relationship with sleep and orthodontic parameters is needed for providing easier and reliable modulatory strategies in the treatment of OSAS.
本研究旨在探讨半快速上颌扩弓（SRME）正畸治疗对阻塞性睡眠呼吸暂停综合征（OSAS）合并上颌横向发育不足儿童生物标志物和呼吸参数的影响。
本研究纳入30例OSAS儿童。15例儿童作为对照组，15例儿童接受SRME正畸治疗5个月。除呼吸参数外，还测量了咽部面积、牙弓、前后宽度以及血清和尿液中OSAS生物标志物的水平。
SRME治疗后咽部气道空间、牙弓和前后宽度增加。睡眠测试显示，在5个月的对照/治疗期后，呼吸暂停低通气指数（AHI）下降。治疗组血清激肽释放酶（KLK）1水平显著降低。5个月随访后，对照组血清类黏蛋白（ORM）2水平显著升高，尿中基底膜聚糖水平降低。观察到血清ORM2、基底膜聚糖、凝溶胶蛋白和KLK1水平与犬齿间宽度之间，以及血清ORM2和KLK1水平与磨牙间宽度之间存在显著负相关。
SRME治疗可被视为OSAS儿童的一种有效治疗方法。需要进一步研究OSAS相关生物标志物及其与睡眠和正畸参数的关系，以便为OSAS治疗提供更简便可靠的调节策略。
