Department of Orthodontics, Dentistry Faculty, Trakya University, 22030 Edirne, Turkey.
Department of Woman, Child and General and Specialist Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy.
J Clin Pediatr Dent. 2024 Jan;48(1):7-18. doi: 10.22514/jocpd.2024.002. Epub 2024 Jan 3.
Nasal septal deviation (NSD) is one of the most common abnormalities impacting the maxillofacial development of children. Herein, we investigated the impact of orthopedic rapid maxillary expansion (RME) on the nasomaxillary complex and NSD in pediatric patients. The study sample consisted of a total of 40 patients divided into two groups. The experimental group included 26 patients (13 females and 13 males) with skeletal maxillary transversal constriction and NSD greater than 1 mm, while the control group comprised 14 patients (6 females and 8 males) with skeletal maxillary transversal constriction but no NSD. All the patients were treated for approximately 15 days with the tooth-tissue born RME device. The activation procedure was to turn the transversal Hyrax screw a quarter turn, twice a day. After that, the device was left in place for a period of five months to facilitate passive retention. Radiographic analysis was performed on posteroanterior (PA) cephalometric radiographs taken at pre-expansion (T1) and post-expansion (T2). The data were evaluated using the Mann-Whitney U and Wilcoxon Sign tests. The experimental group showed a statistically significant decrease ( < 0.05) in the distance from the axis of symmetry to middle of nasal septum (SNM-mid) and to inferior part of the nasal septum (SNI-mid) measurements, indicating a reduction in NSD. Additionally, both experimental and control groups showed a statistically significant increase ( < 0.05) in maxillofacial measurements, including the distance between the nose length (X-SNM and SNM-SNAC), width of the nasal cavity (Pir L-R), basal maxillary width (Mx L-R), vestibular cuspid of upper first molars (CVM + L-R) and lower first molars (CVM-L-R). Based on the study findings, RME was considered effective in achieving craniofacial improvement in pediatric patients with NSD, which positively impacted their healthy growth and development. The improvement in the nasomaxillary complex was similar between genders.
鼻中隔偏曲（NSD）是影响儿童颌面发育的最常见异常之一。在此，我们研究了正畸快速上颌扩张（RME）对儿科患者鼻上颌复合体和 NSD 的影响。研究样本由总共 40 名患者组成，分为两组。实验组包括 26 名患者（13 名女性和 13 名男性），存在骨骼上颌横向狭窄和大于 1 毫米的 NSD，对照组包括 14 名患者（6 名女性和 8 名男性），存在骨骼上颌横向狭窄但无 NSD。所有患者均使用牙组织生的 RME 装置治疗约 15 天。激活程序是每天将横向 Hyrax 螺钉转动四分之一圈，每天两次。然后，将该装置放置五个月以促进被动保持。在扩张前（T1）和扩张后（T2）拍摄后前（PA）头颅侧位片进行放射分析。使用 Mann-Whitney U 和 Wilcoxon 符号检验对数据进行评估。实验组的鼻中隔到鼻中隔中间（SNM-mid）和鼻中隔下部（SNI-mid）测量距离的统计学显着减少（<0.05），表明 NSD 减少。此外，实验组和对照组的颌面测量均有统计学显着增加（<0.05），包括鼻长（X-SNM 和 SNM-SNAC）之间的距离、鼻腔宽度（Pir L-R）、基底上颌宽度（Mx L-R）、上颌第一磨牙的颊尖（CVM + L-R）和下颌第一磨牙（CVM-L-R）。基于研究结果，RME 被认为可有效改善 NSD 儿科患者的颅面，这对他们的健康生长和发育产生了积极影响。性别间鼻上颌复合体的改善相似。
