Three-dimensional image study of accelerated maxillary expansion in oral breathing kids

OBJECTIVE: To evaluate, by a three-dimensional study, the volumetric and integumentary effects of rapid maxillary expansion on the nose, in mouth breathing kids with maxillary hypoplasia, in the short term, assessing the possible interference of gender, growth and age on the results achieved. METHODS: 120 mouth breathing patients with maxilla hypoplasia were divided into an Experimental Group treated by rapid maxillary expansion (n = 104, 62 males and 42 females, mean age 10.1 years, SD = 2.10, ranging from 5.1 to 13.9 years); and Control Group, constituted by 16 patients (9 males and 7 females, mean age 9.3 years, SD = 2.1 years, ranging from 6.1 to 13.2 years). Patients in the experimental group underwent multislice computed tomography examinations at two different times: (T1) pre-expansion and (T2) post-expansion. The control group was submitted to the same tests at the same time intervals. Six soft tissue variables of the nose were studied, besides the volume and area of the nasal cavity, and the measurement and comparison of data between T1 and T2 were performed using the Dolphin Imaging 11.7 Premium software. RESULTS: The experimental group showed significant mean increases in all soft tissue variables studied (p < 0.005), yet there were no significant changes in the control group. In the comparison between groups, only inclination of the nasal dorsum did not present any significant change. CONCLUSION: Rapid maxillary expansion may alter the nasal shape and physiology, by anatomical changes in the nose soft tissues, making it an important aid in the treatment of mouth breathing in childhood. LEVEL OF EVIDENCE: The soft tissues of the nose play an important role in nasal shape and physiology and facial esthetics, and since they are directly related to the nasal valves, they are fundamental for maintenance and stability of the nasal breathing pattern.