多导睡眠图评估不同快速上颌扩张装置对睡眠质量的影响：一项随机临床试验。
Polygraphic evaluation of the effects of different rapid maxillary expansion appliances on sleep quality: A randomized clinical trial.
机构信息
Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi University, Aydınlıkevler Cemil Meriç Boulevard, 6780th Street, No: 48, 35640, Cigli/İzmir, Turkey.
Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey.
出版信息
Sleep Breath. 2023 May;27(2):651-659. doi: 10.1007/s11325-022-02677-0. Epub 2022 Jul 5.
BACKGROUND
The purpose of this clinical study was to assess the effects of different rapid maxillary expansion appliances on the severity of obstructive sleep apnea (OSA).
MATERIAL AND METHODS
Patients having a narrow maxilla and identified with OSA were divided randomly into three groups: tooth tissue-borne, tooth-borne, and bone-borne expanders. Changes in sleep parameters at baseline and 3-month follow-up detected by polygraphy were the primary outcome. Treatment of the crossbite was the secondary outcome. Dunn-Bonferroni tests, Kruskal-Wallis, and Wilcoxon analysis were applied for intra- and inter-group differences at p < 0.05 significance level.
RESULTS
Among 46 patients randomized, apnea-hypopnea index (AHI) changed from baseline to follow-up in all groups (- 1.6, p = 0.280; 0.6, p = 0.691; - 0.45, p = 0.796, respectively), with no between-group difference (p = 0.631). Oxygen desaturation index (ODI) altered from baseline to follow-up in all groups (0.80, p = 0.977; 0.20, p = 0.932; and - 1.00, p = 0.379, respectively), with no between-group difference (p = 0.858). There was no significant difference in minimum oxygen saturation from baseline to follow-up in all groups (0.00, p = 0.401; - 2.00, p = 0.887; 0.50, p = 0.407, respectively). No significant changes were observed in supine AHI from baseline to follow-up in all groups (0.00, p = 0.581; - 1.00, p = 0.393; 0.00, p = 0.972, respectively). The upper intermolar width increased from baseline to follow-up in all groups (5.04, p = 0.000; 3.15, p = 0.001; 5.41, p = 0.00, respectively) with no between-group difference (p = 0.560). Maxillary width increased from baseline to follow-up in all groups (4.25, p = 0.001; 4.74, p = 0.00; 4.49, p = 0.001, respectively) with no inter-group difference (p = 0.963).
CONCLUSIONS
The amount of skeletal and dental expansion obtained in the maxilla was similar in all groups. Rapid maxillary expansion was not found to be effective in OSA treatment.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT04604392.
背景
本临床研究旨在评估不同快速上颌扩张器对上呼吸道阻塞性睡眠呼吸暂停（OSA）严重程度的影响。
材料和方法
将患有上颌狭窄并确诊为 OSA 的患者随机分为三组：牙组织支抗、牙支抗和骨支抗扩弓器。多导睡眠图检测的睡眠参数在基线和 3 个月随访时的变化为主要结局。治疗反颌为次要结局。在 p < 0.05 的显著性水平下，应用 Dunn-Bonferroni 检验、Kruskal-Wallis 和 Wilcoxon 分析进行组内和组间差异。
结果
在随机分组的 46 例患者中，所有组的呼吸暂停低通气指数（AHI）从基线到随访均有变化（分别为-1.6，p=0.280；0.6，p=0.691；-0.45，p=0.796），但组间无差异（p=0.631）。所有组的氧减饱和度指数（ODI）从基线到随访均有变化（分别为 0.80，p=0.977；0.20，p=0.932；-1.00，p=0.379），但组间无差异（p=0.858）。所有组的最低氧饱和度从基线到随访均无显著变化（分别为 0.00，p=0.401；-2.00，p=0.887；0.50，p=0.407）。所有组仰卧位 AHI 从基线到随访均无显著变化（分别为 0.00，p=0.581；-1.00，p=0.393；0.00，p=0.972）。所有组的上颌间宽度从基线到随访均有增加（分别为 5.04，p=0.000；3.15，p=0.001；5.41，p=0.00），但组间无差异（p=0.560）。所有组的上颌宽度从基线到随访均有增加（分别为 4.25，p=0.001；4.74，p=0.00；4.49，p=0.001），但组间无差异（p=0.963）。
结论
上颌获得的骨和牙扩张量在所有组中相似。快速上颌扩张器对 OSA 治疗无效。
试验注册
ClinicalTrials.gov 标识符：NCT04604392。
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